Safe Positioning Reduces Neurovascular Injuries During Robot-Assisted Laparoscopic Prostatectomy

Abstract Objectives: Intra- and postoperative patient safety remains the surgeon's responsibility. During robot-assisted laparoscopic prostatectomy, patients are vulnerable to neuropraxia especially affecting the shoulders and upper and lower limbs while in the Trendelenburg position. Cases of compartment syndrome have also been described. We share our unit's experience on how to reduce the occurrence of intraoperative neurovascular complications. Methods: We have compiled a short but detailed video demonstrating how we position our patient preoperatively for a robot-assisted laparoscopic prostatectomy. Results: In the 4 years we have been running our robotic program, we have noted five cases of self-limiting postoperative arm and leg neuropraxia and two cases requiring fasciotomy for suspected compartment syndrome. Only one case was a true compartment syndrome, as the other was negative on exploration. Our unit continued to work on our technique that was perfected at around patient number 180. Data from ...