title: Adapting the robotic platform to small operating theaters: our experience with the side-docking technique for robotic-assisted laparoscopic prostatectomy.
abstract: Conventionally, in robotic-assisted laparoscopic prostatectomy (RALP), the robot is entered between the abducted legs of the patient. This approach may present drawbacks, including the limited access to the perineum, the inevitable abduction of the patient's legs, and the limited space available in small operating theaters. To overcome these problems, in our center, we use, from over 5 years, a side-docking technique. We herein describe our technique and a series of patients who underwent RALP using such side-docking procedure.
  
  
  
  In our department, we have applied the side-docking technique for over 5 years, mainly in RALP procedures. The series reported includes 268 men undergoing RALP ± extended lymph node dissection (ePLND) between mid-2010 and 2014. After trocart positioning, the robot is entered at a 45° angle compared to the patient's main axis, coming in from the right side. Patient's legs are minimally abducted to <10°.
  
  
  
  Mean docking time, from skin incision to full docking was 13 min. 41 % (109/268) of patients underwent simultaneous ePLND, dissecting nodes up till at least the iliac bifurcation. No conversion to open surgery was required. External collisions are infrequent with this configuration: No re-docking was necessary in this cohort.
  
  
  
  Side-docking of the da Vinci robot is a safe alternative for RALP. In our department, this technique has faced the proof of time and is routinely used.
authors: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium. albisinni.simone@gmail.com.
authors: Simone
authors: S
authors: Albisinni
authors: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium.
authors: Fouad
authors: F
authors: Aoun
authors: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium.
authors: Dam
authors: D
authors: Le Dinh
authors: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium.
authors: Ksenja
authors: K
authors: Limani
authors: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium.
authors: Eric
authors: E
authors: Hawaux
authors: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium.
authors: Alexandre
authors: A
authors: Peltier
authors: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium.
authors: Roland
authors: R
authors: van Velthoven
mesh_terms: D015331:Cohort Studies; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009873:Operating Rooms; D056888:Patient Positioning; D010388:Pelvis / Q000601:surgery; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods
keywords: Docking; Pelvic; Prostatectomy; Robotic; Urology