One of the most important discussions surrounding patient positioning today
revolves around the area of robotic assisted laparoscopy.
The unique technology used by the surgical robot creates unintended consequences with regards to patient positioning.
It has become 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 trocors ultimately result in what has been called "meat hook" restraint technology. When patients slide even "just a little bit" it is the trocars that end up restraining the patient on the table. In his paper, Robotics in Practice: New angles on safer positioning, Dr, Ghomi directly addresses this issue stating:
“Patient slippage during the use of fixed robotic trocars creates a serious potential for patient risk as it can cause incisional tear, post- operative hernia formation, and increased postoperative pain secondary to overstretching of the anterior abdominal wall.”
If the restraint technology does not anchor the patient
in place the patient can slide. Restraints known to
allow patients to slide should not be used for robotic
These links will take you to several published articles describing observations, experiences and recommendations for patient positioning standards for extreme Trendelenburg postures.