Tips for set-up to prevent complications in robotic gynecologic cancer surgery

Robotic surgery (RS) is a breakthrough in gynecologic oncology in the past decade and it is now part of the routine in many centers. Although there is a concern about the oncological outcomes after RS in cervical cancer, it is proven to be safe and effective in endometrial cancer. However, RS has some drawbacks such as the loss of tactile feedback. Complications can therefore occur, and are usually multi-factorial. These can be related to the nature of the operations, the physical fitness of the patients, the control and choice of the devices, and more importantly, the experience and knowledge of the surgical team. To minimise the risk of complications, we need to understand the limitations of RS and have a proper set-up of the operations. It is important to anticipate these potential complications before and during the operations. And a careful setup of the operations, including the instrument set-up, patients’ positioning, port placement, and communication with the anesthetists and surgical team, are crucial in ensuring the safety and success of robotic surgery. In this article, different complications and their preventive measures at set-up were discussed.