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Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society

Purpose: most robot-assisted laparoscopic prostatectomies (RALP) are performed with the patient in lithotomy, carrying risks of positioning-related complications. Newer robot models have allowed for supine positioning, potentially avoiding these pitfalls. We gauged the current sentiment on patient p...

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Detalles Bibliográficos
Autores principales: Wayne, George, Wei, Jeff, Atri, Elias, Wong, Vivian, Garcia-Gil, Maurilio, Pereira, Jorge, Nieder, Alan M, Bhandari, Akshay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872490/
https://www.ncbi.nlm.nih.gov/pubmed/33585117
http://dx.doi.org/10.7759/cureus.12628
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author Wayne, George
Wei, Jeff
Atri, Elias
Wong, Vivian
Garcia-Gil, Maurilio
Pereira, Jorge
Nieder, Alan M
Bhandari, Akshay
author_facet Wayne, George
Wei, Jeff
Atri, Elias
Wong, Vivian
Garcia-Gil, Maurilio
Pereira, Jorge
Nieder, Alan M
Bhandari, Akshay
author_sort Wayne, George
collection PubMed
description Purpose: most robot-assisted laparoscopic prostatectomies (RALP) are performed with the patient in lithotomy, carrying risks of positioning-related complications. Newer robot models have allowed for supine positioning, potentially avoiding these pitfalls. We gauged the current sentiment on patient positioning among surgeons who perform robot-assisted surgery. Methods: we surveyed members of the Endourological Society regarding their practice settings and their opinions on positioning for robot-assisted laparoscopic prostatectomy. Summary statistics were reviewed and data were analyzed using chi-square tests and t-tests. Results: our survey had 92 eligible respondents. The majority were fellowship-trained, with 51% trained in robotics and 57% practicing in the U.S. with a mean of 13 years of practice. Most were working in an academic setting (69%) and performing at least 25 robotic prostatectomies yearly. 28 respondents used the Intuitive Surgical Inc. da Vinci® Xi™ exclusively (30%), and nearly two-thirds used it sometimes. Although 54% of respondents considered using supine positioning, less than half of these surgeons used it regularly, while 75% overall preferred lithotomy. A majority attributed this choice to surgical team familiarity with lithotomy positioning. Surgeons in the U.S. and those using the da Vinci® Xi™ were more likely to consider supine positioning. Conclusions: lithotomy position is the standard for RALP procedures; nonetheless, it poses significant risks that might be avoided with supine positioning. Our survey suggests that, although supine positioning has been considered, it has not gained momentum in practice. Addressing factors of inertia in training practices and one’s surgical team might allow for novel and safer approaches.
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spelling pubmed-78724902021-02-11 Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society Wayne, George Wei, Jeff Atri, Elias Wong, Vivian Garcia-Gil, Maurilio Pereira, Jorge Nieder, Alan M Bhandari, Akshay Cureus Urology Purpose: most robot-assisted laparoscopic prostatectomies (RALP) are performed with the patient in lithotomy, carrying risks of positioning-related complications. Newer robot models have allowed for supine positioning, potentially avoiding these pitfalls. We gauged the current sentiment on patient positioning among surgeons who perform robot-assisted surgery. Methods: we surveyed members of the Endourological Society regarding their practice settings and their opinions on positioning for robot-assisted laparoscopic prostatectomy. Summary statistics were reviewed and data were analyzed using chi-square tests and t-tests. Results: our survey had 92 eligible respondents. The majority were fellowship-trained, with 51% trained in robotics and 57% practicing in the U.S. with a mean of 13 years of practice. Most were working in an academic setting (69%) and performing at least 25 robotic prostatectomies yearly. 28 respondents used the Intuitive Surgical Inc. da Vinci® Xi™ exclusively (30%), and nearly two-thirds used it sometimes. Although 54% of respondents considered using supine positioning, less than half of these surgeons used it regularly, while 75% overall preferred lithotomy. A majority attributed this choice to surgical team familiarity with lithotomy positioning. Surgeons in the U.S. and those using the da Vinci® Xi™ were more likely to consider supine positioning. Conclusions: lithotomy position is the standard for RALP procedures; nonetheless, it poses significant risks that might be avoided with supine positioning. Our survey suggests that, although supine positioning has been considered, it has not gained momentum in practice. Addressing factors of inertia in training practices and one’s surgical team might allow for novel and safer approaches. Cureus 2021-01-11 /pmc/articles/PMC7872490/ /pubmed/33585117 http://dx.doi.org/10.7759/cureus.12628 Text en Copyright © 2021, Wayne et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Urology
Wayne, George
Wei, Jeff
Atri, Elias
Wong, Vivian
Garcia-Gil, Maurilio
Pereira, Jorge
Nieder, Alan M
Bhandari, Akshay
Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society
title Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society
title_full Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society
title_fullStr Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society
title_full_unstemmed Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society
title_short Trends in Positioning for Robotic Prostatectomy: Results From a Survey of the Endourological Society
title_sort trends in positioning for robotic prostatectomy: results from a survey of the endourological society
topic Urology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872490/
https://www.ncbi.nlm.nih.gov/pubmed/33585117
http://dx.doi.org/10.7759/cureus.12628
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