title: Side docking of the da Vinci robotic system for radical prostatectomy: advantages over traditional docking.
abstract: The standard low lithotomic position, used during robot-assisted radical prostatectomy (RARP), with prolonged positioning in stirrups together with steep Trendelenburg may expose the patient to neurapraxia phenomena of the lower limbs and can rarely be used in patients with problems of hip abduction. To overcome these hurdles, we evaluated the clinical benefits of "side docking" (SD) of the da Vinci(®) robotic system in comparison to "traditional docking" (TD). A cohort of 120 patients submitted to RARP were prospectively randomized into two groups by docking approach: SD with the patient supine with lower limbs slightly abducted on the operating table, and TD docking time, intraoperative number of collisions between the robotic arms and postoperative neurological problems in the lower limbs were noted. Descriptive statistics was used to analyze outcomes. Docking time was shorter for the SD group [SD: median 13 min (range 10-18); TD: median 21 min (range 15-34)]. None in the SD group and six of 60 patients (10%) in the TD group suffered from temporary (<30 days) unilateral neurological deficits of the lower limbs. In both groups no collisions between the robotic arms occurred. The SD approach is technically feasible. It does not cause collisions between the robotic arms, and is a reliable method for reducing the setup time of RARP. The supine position of the patient may prevent neurological complications of the lower limbs. Based on these results, SD has become the standard docking technique used by our department.
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cestari
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. em.ferrari@alice.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferrari
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanoni
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Sangalli
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Ghezzi
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Fabbri
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sozzi
authors.affiliation: Department of Urology, Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000601:surgery; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Da Vinci robotic system; Prostate cancer; Radical prostatectomy; Side docking