Advances in robotic-assistedlaparoscopic surgery have exponentially increased since the introduction of the da Vinci® Surgical System (Intuitive Surgical Inc., Sunnyvale, CA). Robotic surgery has become more prevalent in many centers of surgical excellence around the world. The radical retropubic prostatectomy for treatment of prostate cancer has become a focal point of experience for robotic-assisted operations in the pelvis. The most common robotic-assisted renal operation has been the dismembered pyeloplasty. Although necessary long-term follow-up of these procedures has not yet been achieved, it is becoming increasingly apparent that robotic technology is changing the standard of care for complex urologic procedures. In this chapter, we describe logistical issues pertaining to patient positioning for these two most commonly performed urologic operations. Emphasis will be placed on patient and staff safety issues, ergonomics, and optimizing surgical exposure.
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