“Patient slippage during the use of fixed robotic trocars creates a serious potential or patient risk as it can cause incisional tear,post-operative hernia

formation, and increased postoperative pain

secondary to overstretching of the anterior

abdominal wall.”

"All patients undergoing robotic surgical procedures using the Trendelenburg position are at risk for positioning related injuries."

"The unique computer assisted technology utilized by the surgical robot has created unintended consequences with regards to patient positioning.​"

 "It is becoming obvious that any sliding at

 all during robotic surgery creates added  patient risk of injury and unnecessary  postoperative pain."

      Since the earliest days of the robot there has been a substantial void between traditional patient positioning guidelines and devices for traditional laparoscopy and the real world patient positioning equipment and guideline requirements for robotic surgery.      The need for innovative  generational robot compatible accessories eclipses the traditional positioning guidelines of laparoscopy and has more to do with patient safety than ever before. 

      Conditions occur In robotic surgery, not present in traditional laparoscopic procedures, that place patients at risk for serious positioning related injury.  The need for new guidelines and well thought out next generation, robot compatible, accessories is paramount to patient safety.           
       It is becoming obvious that any sliding at all during robotic surgery creates added patient risk of injury and unnecessary postoperative pain.  This risk occurs because the robots are not programmed to change 

the location of the robotic arm, instruments and trocars to compensate for patient sliding.
    Fixed position trocors ultimately result in what has been called the "meat hook" restraint technique.  When patients slide even "just a little bit" it is the trocars that end up restraining the patient on the table.  

      Dr, Ghomi directly addresses this issue in his paper stating - 

  It is clear that Trendelenburg restraint technology that is not 100% capable of consistently and reliably anchoring the patient in position should be taken out of service for use during robotic procedures.