Principles and Practice of Robotic Surgery

?General principles



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



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




Port placement





Establishing pneumoperitoneum






Hasson
Veress
Optical
Insufflation pressure






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




Docking the robot





Modelled on Device teaching






Targeting
Ensuring adequate space between arms
Burping




Safety





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




Instruments





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




Diathermy settings
Console

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

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