Side Docking the Robot for Robotic Laparoscopic Radical Prostatectomy

Abstract

Low lithotomy position with the robot between the legs for docking is a standard position for robotic radical prostatectomy. Its complications include occasional nerve injury and compartment syndrome. In some patients with conditions that limit hip abduction, this position may be infeasible. We report a docking technique that obviates stirrups and simplifies setup without altering surgical technique. A total of 100 consecutive patients underwent robotic radical prostatectomy for localized prostate cancer. Fifty patients (group 1) were in the standard lithotomy position, and the remaining 50 patients (group 2) were in slight trendelenburg position with the robot at the side of the bed - "side-docked." Setup and docking times were recorded and both groups were compared for differences in operative variables. Mean setup time for group 2 was 4.7 minutes shorter than for group 1 (p = 0.02). Docking time and other operative variables were statistically similar and not affected by the adoption of side-docking technique. However, overall surgical time was longer due to modifications in other aspects of the technique during the study period. Side-docking for robotic radical prostatectomy is associated with small but significant improvement in setup time and can be utilized in patients with limited hip abduction.