Giuseppe Quarto*, Domenico Sorrentino, Raffaele Muscariello and Sisto Perdonà
Department of Urology, Istituto Tumori of Naples “G.Pascale”, ItalyFulltext PDF
Introduction: Robot-assisted radical prostatectomy is performed routinely with central docking. This positioning can be associated with perineal nerve injury and compartment syndromes in rare cases. Moreover, the low lithotomy may not be feasible in patients with a history of bilateral hip arthroplasty which typically limits abduction position. In this study we investigate the feasibility and safety of side-docking techniques in robot-assisted urologic pelvic surgery.Method: 192 consecutive patients from March 2013 to September 2016 undergoing robot-assisted radical prostatectomy participated in the study and randomized in two, groups: Group a (n 96) with side docking and Group B (n 96) central docking. Each patient was placed in the lithotomy- Trendelenburg position. The result was comparated in terms of docking time, operative time, and complication rate.Results: All the procedures were completed without the need for redocking. No significant collision between the robotic arms occurred. There was no Clavien-Dindo III-V complication in any case. Mean docking time was 5.7 min Group A and 6.2 min Group B Mean operative times was 123 minutes for group A and 125 for group B. All the procedures were completed without the need for redocking. No significant robot arm collision occurred. The mean hospital stay was 4 days (range 3-9 days). There was no Clavien-Dindo grade III-V complication in our series.Discussion and
Conclusion: Side docking for robotic radical prostatectomy is a viable alternative positioning technique for patients with hip abduction limitations to the standard low lithotomy positioning. Major alterations with the surgical technique are not required, and the perioperative outcomes are comparable to outcomes with the standard low lithotomy positioning.
Quarto G, Sorrentino D, Muscariello R, Perdona S. Side Docking vs. Central Docking in Robotic Assisted Laparoscopic Prostatectomy with daVinci Si: a Randomized Study. Clin Surg. 2017; 2: 1843.