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International Surgery and Ortho Conference
October 25-26, 2017 | Toronto, Canada
Case Rep Surg Invasive Proced 2017 | Volume 1 Issue 3
Robotic surgery and patient positioning: Ergonomics, clinical pearls and review of literature
Shagun Bhatia Shah
Rajiv Gandhi Cancer Institute and Research Centre, India
Statement of the problem:
Robotic surgery has revolutionised
patient management and opened newer doors for the
anaesthesiologists regarding patient safety. Patient positioning
and operation theatre (OT) configuration assumes unique
importance for robotic surgery due to multiple factors. First
and fore-most, the position cannot be changed once the
robot is docked. Further, adequate surgical exposure requires
extreme positioning and revamping of the existing positioning
devices. In addition, there is restricted access to the patient
and its antecedent problems. Last, but not the least, space
restriction and protection of patient from the clashing robotic
arms requires special devices and several unfavourable position
modifications. Position related nerve palsies, pressure ulcers,
port site necrosis, venous thrombosis and other injuries are
on the rise in the recent years and appropriate measures may
make it largely preventable.
Methodology:
Our experience of providing perioperative and
anaesthetic care for more than 2500 robotic surgeries (various
surgical disciplines) hashelpedushighlight themajorpositioning
associated deficiencies and problems during robotic surgeries.
We have also attempted to find practical solutions for the same,
and to define the best practices for robotic positioning using a
thorough review of literature.
Speaker Biography
Shagun Bhatia Shah is a motivated and dedicated Anesthesiologist with 16 years of
experience in the field of Anesthesia. Her interest in Onco-anesthesia drove her to
practice as a Consultant at RGCI and RC. She is especially interested in recent advances
in anaesthesia like USG guided lines, nerve blocks, epidurals and anaesthesia for
robotic surgery. She is certified in TEE (trans esophageal echocardiography) use and
utilizes it for managing cardiac patients undergoing noncardiac Onco-anesthesia.
She has successfully conducted clinical trials like “Optic nerve sheath diameter
guided noninvasive ICP measurement in patients undergoing robotic surgery in steep
Trendelenberg position” and is presently conducting the trial “TEE for intraoperative
goal directed fluid therapy in cardiac patients undergoing non-cardiac Onco-anesthesia
and robotic surgery in ST position” among others. She is ready to walk that extra mile
with post- operative and terminally ill cancer patients to alleviate their pain and
suffering.
e:
drshagun_2010@rediffmail.com