title: Trendelenburg position in gynecologic robotic-assisted surgery.
abstract: OBJECTIVE
  To estimate the necessity of routine patient positioning in steep Trendelenburg in robotic-assisted gynecologic surgery performed for benign indications.
  
  
  METHODS
  Descriptive study (Canadian Task Force classification II-2).
  
  
  METHODS
  University-affiliated community hospital.
  
  
  METHODS
  Twenty women undergoing robotic-assisted gynecologic surgery for benign indications.
  
  
  METHODS
  Robotic-assisted total hysterectomy, supracervical hysterectomy, myomectomy, and sacrocolpopexy.
  
  
  RESULTS
  Demographic data and perioperative variables were recorded including age, body mass index, procedure type, console time, perioperative complications, estimated blood loss, hospital length of stay, and degree of Trendelenburg position. The degree of Trendelenburg position was measured at the end of each procedure using an electronic level. The surgeons were blinded to the degree of Trendelenburg used. All procedures were performed successfully without conversion to laparotomy. All patients were discharged to home within 24 hours. No perioperative complications were noted. The mean (SD; 95% CI) Trendelenburg position used in this cohort was 16.4 (4.1; 14.4-18.3) degrees. Patient body mass index was 28.5 (5.3; 26.1-31.1). Median console time was 87.5 (27-112) minutes.
  
  
  CONCLUSIONS
  Robotic-assisted benign gynecologic surgery can be effectively performed without use of the steep Trendelenburg position. The practice of routine adherence to steep Trendelenburg positioning in benign gynecologic robotic surgery should be questioned.
authors: Department of Obstetrics and Gynecology, Sisters of Charity Hospital, Buffalo, New York 14214, USA. aghomi@yahoo.com
authors: Ali
authors: A
authors: Ghomi
authors: Christina
authors: C
authors: Kramer
authors: Reza
authors: R
authors: Askari
authors: Niraj R
authors: NR
authors: Chavan
authors: Jon I
authors: JI
authors: Einarsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D005260:Female; D018475:Head-Down Tilt; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D056888:Patient Positioning; D056887:Pelvic Organ Prolapse / Q000601:surgery; D012371:Robotics; D016037:Single-Blind Method; D013997:Time Factors