Patient Positioning and Trocar Placement for Robotic Urologic Procedures

  • Rajan Ramanathan
  • Robert I. Carey
  • Alvin Lopez-Pujals
  • Raymond J. Leveillee


Robotic-assisted laparoscopic urologic surgery is fast becoming established as a standard of care for many urologic diseases. As more experience and long-term follow-up of procedures is accumulating, the safety of robotic technology is becoming well established. In this chapter we wish to describe logistical issues pertaining to patient positioning for the two areas of commonly performed urologic operations: those in the pelvis (prostate/ureter/bladder), and those for the upper tract (kidney/ureter/adrenal), in and around the kidney. General principles of patient positioning and port placement will be described followed by specific examples of complex situations, and how to overcome them.


Robotic urologic procedures Robotic prostatectomy Positioning for robotic surgery Trocar and port placement for robotic surgery 


  1. 1.
    Pick DL, Lee DI, Skarecky DW, Ahlering TE. Anatomic guide for port placement for daVinci robotic radical prostatectomy. J Endourol. 2004;18(6):572-575.PubMedCrossRefGoogle Scholar
  2. 2.
    Mandhani A, Tewari AK, Berryhill R Jr. Athermal robotic technique of radical prostatectomy: an assistant’s perspective. Arch Esp Urol. 2007;60(4):375-382.PubMedCrossRefGoogle Scholar
  3. 3.
    Cestari A, Buffi NM, Scapaticci E, et al. Simplifying patient positioning and port placement during robotic-assisted laparoscopic prostatectomy. Eur Urol. 2010;57(3):530-533.PubMedCrossRefGoogle Scholar
  4. 4.
    Eun D, Bhandari A, Boris R, Rogers C, Bhandari M, Menon M. Concurrent upper and lower urinary tract robotic surgery: strategies for success. BJU Int. 2007;100(5):1121-1125.PubMedGoogle Scholar
  5. 5.
    Gettman MT, Hoznek A, Salomon L, et al. Laparoscopic radical prostatectomy: description of the extraperitoneal approach using the da Vinci robotic system. J Urol. 2003;170(2 Pt 1):416-419.PubMedCrossRefGoogle Scholar
  6. 6.
    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):683-692; viii.PubMedCrossRefGoogle Scholar
  7. 7.
    Kurzer E, Leveillee RJ. Laparoscopic lymph node dissection in urologic cancer. Surg Oncol Clin N Am. 2005;14(2):353-365.PubMedCrossRefGoogle Scholar
  8. 8.
    Carmack AJ, Siddiq FM, Leveillee RJ. Novel use of da Vinci robotic surgical system: removal of seminal vesicle cyst in previously dissected pelvis. Urology. 2006;67(1):199.PubMedCrossRefGoogle Scholar
  9. 9.
    Siddiq FM, Leveillee RJ, Villicana P, Bird VG. Computer-assisted laparoscopic pyeloplasty: University of Miami experience with the daVinci surgical system. J Endourol. 2005;19(3):387-392.PubMedCrossRefGoogle Scholar
  10. 10.
    Rogers CG, Singh A, Blatt AM, Linehan WM, Pinto PA. Robotic partial nephrectomy for complex renal tumors: surgical technique. Eur Urol. 2008;53(3):514-521.PubMedCrossRefGoogle Scholar
  11. 11.
    Kaul S, Laungani R, Sarle R, et al. da Vinci-assisted robotic partial nephrectomy: technique and results at a mean of 15 months of follow-up. Eur Urol. 2007;51(1):186-191; discussion 191-192.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  • Rajan Ramanathan
    • 1
  • Robert I. Carey
    • 2
  • Alvin Lopez-Pujals
    • 3
  • Raymond J. Leveillee
    • 4
  1. 1.Cleveland ClinicGlickman Urological and Kidney InstituteGarfield HeightsUSA
  2. 2.Department of UrologyFlorida State University College of MedicineSarasotaUSA
  3. 3.Department of Urology, Puerto Rico Medical CenterUniversity of Puerto Rico School of MedicineSan JuanPuerto Rico
  4. 4.Division of Endourology and Laparoscopy Department of UrologyUniversity of MiamiMiamiUSA

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