By Pierre Mozer, Jocelyne Troccaz, Dan Stoianovici (auth.), Li-Ming Su (eds.)
The Atlas of robot Urologic surgical procedure offers a close, step by step consultant to universal robot urologic systems for the aim of assisting amateur surgeons of their transition to robot surgical procedure and professional robot surgeons to refine their surgical method and extend their repertoire of robot systems. moreover, much less normally played robot techniques akin to these for male infertility, pelvic organ prolapse, urinary tract reconstruction and pediatrics are incorporated. every one bankruptcy is written through the concept leaders in robot urologic surgical procedure with descriptive step by step textual content, complimented via figures and intraoperative images detailing the nuances of every approach. Emphasis is put on operative setup, tool and kit wishes and surgical ideas for either the first health care professional in addition to the operative assistant. using ancillary apparatus and robot software and endoscope exchanges are highlighted in the course of the procedural textual content by way of tables designed to assist surgeons and their groups in enhancing potency. This quantity will supply designated insights into robot urologic surgical procedure and decrease the educational curve of attaining those more and more well known procedures.
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Extra resources for Atlas of Robotic Urologic Surgery
The trocars for the S system also have a trocar that can be connected to the insufflator. Also shown are the sharp and blunt obturators used for trocar placement 19 inserted with the thick black band at the level of the abdominal fascia. This acts as the pivot point for the trocar and robotic instrument arm. It is recommended that the robotic trocars be placed at least 8–10 cm away from the camera to avoid instrument arm collision and facilitate intracorporeal suturing. In addition, the angle created by the robotic and camera trocars should be greater than 90° to increase instrument arm maneuverability [1, 3].
Preoperative Preparation Patients are typically screened preoperatively with an EKG, chest x-ray, complete blood count, chemistries, coagulation profile, and urinalysis with culture if indicated. We recommend a clear liquid diet the day before surgery and then nothing by mouth after midnight. A laxative is self administered the night before surgery. Upon arrival to the operating room, parenteral antibiotics are administered prior to skin incision. Sequential compression boots are routinely used in all patients.
We have used a figure-of-eight suture that is pexed into the pubic periosteum. This helps elevate the urethra after division of the prostatic apex which helps to visualize the urethra during the anastomosis and may be associated with recovery of urinary continence. Often, a back-bleeding suture is also placed toward the prostate base. Once tied, the DVC can be divided at this point, but many surgeons leave this intact temporarily until the urethra is approached later during the case. 0 mm staple length.