Robot-assisted surgery, soon to be incorporated into most surgical disciplines, can reduce postoperative complications by up to 50%, and has been shown to result in reduced blood loss, earlier hospital discharge, and faster return to normal activity for the patient. Edited by master surgeon Tony Costello, and with contributions from the world’s best and most experienced robotic surgeons worldwide, Principles and Practice of Robotic Surgery is an up-to-date, all-in-one reference that provides step-by-step instruction for practicing surgeons and those who are entering robotic surgery training. This first-of-its-kind text discusses new technologies and their application in each surgical subspecialty, with hundreds of outstanding illustrations and high-quality videos—making this an ideal resource for the entire OR team.

General principles

1. Anesthesia for robotic surgery

• Physiology of pneumoperitoneum
• Complications

• Air embolism
• Arrest… etc

• Preoperative assessment and patient selection
• Patient positioning and prevention of injury

Bedside – including port placement and docking

1. Draping robot

• (basic understanding in order to be able to deal with trouble shooting)
• Need all 4 arms to be draped even if not using

1. Port placement

• Establishing pneumoperitoneum

• Hasson
• Veress
• Optical
• Insufflation pressure

• Complications and trouble shooting
• Eg. Adhesions, Obesity, Narrow pelvis, Prior surgery or radiotherapy, Existing stoma

1. Docking the robot

• Modelled on Device teaching

• Targeting
• Ensuring adequate space between arms
• Burping

1. Safety

• e.g. height limitation
• Locking instruments to avoid drift
• Emergency undocking
• Trouble shooting errors and faults

1. Instruments

• Familiarity with commonly used laparoscopic instruments for the bedside assistant
• Inserting and exchanging instruments

1. Diathermy settings

Console

2. How does it all work?

• Basic rundown of buttons etc
• Controlling the camera

• Use of different lenses and changing view
• Understanding when/why to use different lens

• Swapping between instruments
• Fourth arm control
• Clutching
• Customising your setup
• Ergonomics
• Scaling ratio movement

• Adjusts movement speed to surgeon preference
• Default 3:1, 2:1, 1.5:1

• Available instruments
• Diathermy settings