Summary of ‘Improved positioning in robotic assisted laparoscopic partial nephrectomy using the EDGE MP1000 surgical robot’
Renal cancer is a prevalent malignancy within the urinary system, and surgical resection remains the primary treatment option. The adoption of minimally invasive techniques, particularly robotic-assisted laparoscopic partial nephrectomy, has gained traction for managing T1 stage renal tumours. However, maintaining a fixed position during surgery poses challenges, including increased risks of pressure injuries due to the prolonged immobility of patients.
Objectives
The study aimed to assess the impact of improved body positioning on the effectiveness of robotic-assisted laparoscopic partial nephrectomy using the EDGE MP1000 surgical robot. It specifically compared traditional positioning methods with a newly designed precise positioning protocol implemented at Zhujiang Hospital of Southern Medical University.
Methodology
The study included 39 patients who underwent the procedure between November 2023 and May 2024. These patients were divided into two groups: a control group consisting of 18 patients who received conventional positioning and an experimental group of 21 patients who benefited from precise positioning techniques, including assessments, optimized positioning methods, and enhanced nursing measures.
Key metrics evaluated included the duration of positioning, the incidence of intraoperative pressure injuries, and patient satisfaction. Notably, all procedures were completed successfully, highlighting the feasibility of the new positioning approach.
Results
The findings revealed that the experimental group experienced a significantly shorter duration of postural placement (P < 0.001) and a lower incidence of intraoperative stress injuries (P = 0.023) compared to the control group. Additionally, patient satisfaction scores were markedly higher in the experimental group (P < 0.001), indicating a positive response to the new positioning protocol.
Discussion
Robotic-assisted surgeries, while offering precision and reduced recovery times, require careful attention to patient positioning to prevent complications. The research highlighted that traditional positioning methods often lead to inadequate exposure and increased risk of pressure injuries. The study introduced a custom 70° lateral decubitus cushion and a precise positioning fixation kit that simplified the positioning process and enhanced patient safety.
The study also emphasized the importance of thorough preoperative education and meticulous management of surgical positioning throughout the perioperative period. The adoption of these new techniques not only improved operational efficiency but also enhanced the overall satisfaction of the surgical team.
Conclusion
In conclusion, the implementation of improved positioning strategies for robot-assisted laparoscopic partial nephrectomy using the EDGE MP1000 surgical robot significantly reduced positioning times and the incidence of intraoperative pressure injuries. The study advocates for the clinical adoption of these techniques to enhance surgeon satisfaction and ensure patient safety. However, the authors acknowledge the study’s limitations, including its single-centre design and the relatively small sample size, suggesting that further research across multiple centres is essential for broader applicability of the findings.
This research contributes valuable insights into optimizing surgical positioning in robotic-assisted procedures and underscores the need for ongoing innovation in surgical practices to improve patient outcomes.
SOURCE: https://link.springer.com/article/10.1007/s11701-024-02183-3
