Side-docking Technique for Robot-assisted Urologic Pelvic Surgery

OBJECTIVE To investigate the feasibility of side-docking techniques in robot-assisted urologic pelvic surgery. MATERIALS AND METHODS Six consecutive patients undergoing robot-assisted pelvic surgery participated in the study: 3 undergoing radical cystectomy for muscle-invasive bladder cancer, 1 patient undergoing ureteroneocystostomy for ureteric stricture, 1 patient undergoing partial cystectomy for urothelial cancer in a bladder diverticulum, and 1 undergoing transvesical simple prostatectomy. Each patient was placed in the lithotomy-Trendelenburg position, with the robot docked over the patient's right side. RESULTS All the procedures were completed without the need for redocking. Simultaneous cystour-ethroscopy was performed in 1 case to localize a bladder diverticular tumor during a partial cystectomy. Manipulation of the uterus and perineum was possible by the second assistant sitting between the patients' legs. No significant collision between the robotic arms occurred. There was no Clavien-Dindo III-V complication in any case. CONCLUSION Side docking for robot-assisted urologic pelvic surgery is a viable positioning alternative with the advantage of enhanced access to the perineum and urethra. This modified approach will be useful in robot-assisted radical cystectomy and other reconstructive urologic procedures. (C) 2013 Elsevier Inc.