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The Robotic Patient-Side Assistant

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Robotics in Genitourinary Surgery
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Abstract

A team-based approach in the robotic operating room is critical for success and the patient-side first assistant is central to this team. A well-trained assistant is necessary to maximize efficiency and minimize complications. The assistant needs to understand and manage a multitude of issues including the plethora of equipment, safe patient positioning, gaining safe access into the abdomen, optimal port placement, efficient robot docking, managing insufflation and optimizing the robotic performance during the case. The assistant needs to be facile, ambidextrous laparoscopist and an effective communicator with the console surgeon and the rest of the team. An assistant who can troubleshoot effectively and quickly respond to problems and complications can make a major difference in the outcome of the operation. We review all salient aspects of the role and considerations of an effective and experienced patient-side assistant. Although the job is often thankless and underappreciated, the patient-side assistant is a key member of the robotics team and crucial for successful outcomes.

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References

  1. Kumar R, Hemal AK. The ‘scrubbed surgeon’ in robotic surgery. World J Urol. 2006;24(2):144–7.

    Article  PubMed  Google Scholar 

  2. Menon M, Shrivastava A, Tewari A, Sarle R, Hemal A, Peabody JO, et al. Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol. 2002;168(3):945–9.

    Article  PubMed  Google Scholar 

  3. Lee DI, Eichel L, Skarecky DW, Ahlering TE. Robotic laparoscopic radical prostatectomy with a single assistant. Urology. 2004;63(6):1172–5.

    Article  PubMed  Google Scholar 

  4. Kaul SA, Peabody JO, Shah N, Neal D, Menon M. Establishing a robotic prostatectomy programme: the impact of mentoring using a structured approach. BJU Int. 2006;97(6):1143–4.

    Article  PubMed  Google Scholar 

  5. Grover S, Tan GY, Srivastava A, Leung RA, Tewari AK. Residency training program paradigms for teaching robotic surgical skills to urology residents. Curr Urol Rep. 2010;11(2):87–92.

    Article  PubMed  Google Scholar 

  6. Luthringer T, Aleksic I, Caire A, Albala DM. Developing a successful robotics program. Curr Opin Urol. 2012;22(1):40–6.

    Article  PubMed  Google Scholar 

  7. Lee JY, Mucksavage P, Sundaram CP, McDougall EM. Best practices for robotic surgery training and credentialing. J Urol. 2011;185(4):1191–7.

    Article  PubMed  Google Scholar 

  8. Mills JT, Burris MB, Warburton DJ, Conaway MR, Schenkman NS, Krupski TL. Positioning injuries associated with robotic assisted urological surgery. J Urol. 2013;190(2):580–4.

    Article  PubMed  Google Scholar 

  9. Phong SV, Koh LK. Anaesthesia for robotic-assisted radical prostatectomy: considerations for laparoscopy in the Trendelenburg position. Anaesth Intensive Care. 2007;35(2):281–5.

    PubMed  CAS  Google Scholar 

  10. Badilo FL, Goldberg G, Pinkhasov G, Badillo C, Sultan RC. Secure patient positioning using Badillo/Trendelenburg restraint strap during robotic surgery. J Robot Surg. 2014;8:239–43.

    Article  Google Scholar 

  11. Hemal AK, Eun D, Tewari A, Menon M. Nuances in the optimum placement of ports in pelvic and upper urinary tract surgery using the da Vinci robot. Urol Clin North Am. 2004;31(4):683–92. viii.

    Article  PubMed  Google Scholar 

  12. Ahmad G. Laparoscopic entry techniques. Cochrane Database Sys Rev. 2015;(8): Art. no. CD006583.

    Google Scholar 

  13. McKernan JB, Champion JK. Access techniques: Veress needle—initial blind trocar insertion versus open laparoscopy with the Hasson trocar. Endosc Surg Allied Technol. 1995;3(1):35–8.

    PubMed  CAS  Google Scholar 

  14. Moberg AC, Montgomery A. Primary access-related complications with laparoscopy: comparison of blind and open techniques. Surg Endosc. 2005;19(9):1196–9.

    Article  PubMed  Google Scholar 

  15. Azevedo OC, Azevedo JL, Sorbello AA, Miguel GP, Wilson Junior JL, Godoy AC. Evaluation of tests performed to confirm the position of the Veress needle for creation of pneumoperitoneum in selected patients: a prospective clinical trial. Acta Cir Bras. 2006;21:385–91.

    Article  PubMed  Google Scholar 

  16. Molloy D, Kaloo PD, Cooper M, Nguyen TV. Laparoscopic entry: a literature review and analysis of techniques and complications of primary port entry. Aust N Z J Obstet Gynaecol. 2002;42(3):246–54.

    Article  PubMed  Google Scholar 

  17. Gett RM, Joseph MG. A safe technique for the insertion of the Hasson cannula. ANZ J Surg. 2004;74(9):797–8.

    Article  PubMed  Google Scholar 

  18. Rosen DM, Lam AM, Chapman M, Carlton M, Cario GM. Methods of creating pneumoperitoneum: a review of techniques and complications. Obstet Gynecol Surv. 1998;53(3):167–74.

    Article  CAS  PubMed  Google Scholar 

  19. Horstmann M, Horton K, Kurz M, Padevit C, John H. Prospective comparison between the AirSeal® system valve-less trocar and a standard Versaport ™ Plus V2 trocar in robotic assisted radical prostatectomy. J Endourol. 2013;27:579–82.

    Article  PubMed  Google Scholar 

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Correspondence to Daniel D. Eun .

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Mucksavage, P., Eun, D.D. (2018). The Robotic Patient-Side Assistant. In: Hemal, A., Menon, M. (eds) Robotics in Genitourinary Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20645-5_7

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  • DOI: https://doi.org/10.1007/978-3-319-20645-5_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20644-8

  • Online ISBN: 978-3-319-20645-5

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