Combined Use of a Ramped Position Pillow and Bean Bag in a Morbidly Obese Patient Undergoing Robotic Pelvic Surgery:...

Vacuum bean bags improve patient stability and reduce pressure- and nerve-related injuries during pelvic robotic surgery. In morbidly obese patients, the ramped position enhances airway management and ventilation, but maintaining it throughout surgery can be challenging. We report a case in which a ramped pillow was kept atop a vacuum bean bag for the entire procedure, eliminating the need for repositioning after intubation and before extubation. This approach minimized airway and line displacement, reduced staff strain, and preserved optimal oxygenation and ventilation during emergence and post-extubation. The case highlighted the importance of individualized, tailored positioning strategies for morbidly obese patients undergoing prolonged robotic procedures.