The standard low lithotomic position, used during robot-assisted radical prostatectomy (RARP), with prolonged positioning in stirrups together with steep Trendelenburg may expose the patient to neurapraxia phenomena of the lower limbs and can rarely be used in patients with problems of hip abduction.
To overcome these hurdles, we evaluated the clinical benefits of "side docking" (SD) of the da Vinci(®) robotic system in comparison to "traditional docking" (TD). A cohort of 120 patients submitted to RARP were prospectively randomized into two groups by docking approach: SD with the patient supine with lower limbs slightly abducted on the operating table, and TD docking time, intraoperative number of collisions between the robotic arms and postoperative neurological problems in the lower limbs were noted. Descriptive statistics was used to analyze outcomes. Docking time was shorter for the SD group [SD: median 13 min (range 10-18); TD: median 21 min (range 15-34)]. None in the SD group and six of 60 patients (10 %) in the TD group suffered from temporary (
Journal of robotic surgery. 2015 Jul 24 [Epub]
Andrea Cestari, Matteo Ferrari, Matteo Zanoni, Mattia Sangalli, Massimo Ghezzi, Fabio Fabbri, Francesco Sozzi, Patrizio Rigatti
Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. , Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. , Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. , Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. , Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. , Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. , Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.