|
M.J. Fumo1, K.K. Badani , S. Kaul , A. Shrivastava , S. Dusik-Fenton , F. Ogunfitidimi , S. Murali , N. Ashani , K. Arumunga , R.H Littleton , J.O. Peabody , R.M. Sahabudin , A.K. Hemal ,M. Menon
1Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, Institute of Urology and Nephrology, 2Hospital Kuala Lumpur
Introduction: The DaVinci robotic system has the advantages of 3D imaging, magnification, and precise movements with many degrees freedom; however, it is hampered by size making optimal port placement essential to prevent loss of range of motion from robotic arms colliding with each other or the patient's body. We seek to clarify optimal port placement for transperitoneal renal surgery.
Method: Over a two-week period 35 robotic renal surgeries including total and partial nephrectomy, pyeloplasty, and pyelolithotomy were performed. Detailed written notes and photographs of initial and final port placement were made. Particular attention was paid to loss of range of motion, lack of reach, or arm clashing.
Result: Through trial and error the best patient position was the full flank position with minimal table flexion and with the patient moved to the edge of the table such that any abdominal fat would fall away from the working area. The port placement that resulted in no loss of range of motion consisted of a 12mm camera port placed laterally between the anterior axillary line and the midclavicular line 3-4 cm below the costal margin, and two 8mm robotic ports each placed 10-11 cm away from the camera port such that a right triangle is formed. All operations were completed without collision or loss of range of motion.
Conclusion: Robotic port placement for renal surgery can be optimized to eliminate loss of range of motion. Placing the camera port laterally and robotic ports antero-medially resulted in considerable flexibility of robotic movement. Please log-in or register in order to submit comments. Powered by AkoComment! |
Conference Coverage 
