title: Optimizing robotic renal surgery: the lateral camera port placement technique and current results.
abstract: OBJECTIVE
  The successful completion of robot-assisted renal surgery requires optimal port placement in order to minimize arm collisions due to the bulky nature of the robotic system. We describe a novel technique of port placement to maximize range of motion during robotic renal surgery that has been used successfully in over 50 procedures and report on our results.
  
  
  METHODS
  Five primary ports are placed utilizing a 30 degrees lens facing upward. The camera is in the most laterally placed port between the anterior axillary line and the midclavicular line, 3 to 4 cm below the costal margin. Two 8-mm robotic ports are placed 10 to 11 cm away from the camera port, triangulated towards the kidney. Assistant ports, if desired, are located medially and placed supra- (12 mm) and infraumbilically (5 mm).
  
  
  RESULTS
  This technique resulted in the camera arm residing in an upward position, moving in a completely separate plane from the working robotic arms. We had no incidents of arm-camera collision in this position. We have used this port placement technique successfully in over 50 cases performed entirely robotically. We have had no need to change port location, redock the robotic system, or add additional ports during a procedure.
  
  
  CONCLUSIONS
  We report on a port placement technique for robotic renal surgery that optimizes motion of the robotic arms, while eliminating external collisions. Placement of the camera port laterally and robotic ports anteromedially results in considerable flexibility of robotic arm movement.
authors: Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA. ketanbadani@gmail.com
authors: Ketan K
authors: KK
authors: Badani
authors: Fred
authors: F
authors: Muhletaler
authors: Michael
authors: M
authors: Fumo
authors: Sanjeev
authors: S
authors: Kaul
authors: James O
authors: JO
authors: Peabody
authors: Mahendra
authors: M
authors: Bhandari
authors: Mani
authors: M
authors: Menon
mesh_terms: D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D020706:Laparoscopes; D008297:Male; D012371:Robotics; D013520:Urologic Surgical Procedures / Q000295:instrumentation*