da vinci robot poll

Ummm, nope. We don't even have computer charting yet.

Yes - We have a DaVinci robot and it is used exclusively by our Urology group for prostatectomies and some nephrectomy procedures.

We have the robot for 3+ years and we use it everyday in either urology or thoracic service. We average about 10 cases a week.

In Urology, we do mostly prostatectomies and some pyeloplasties. Our 1st robotic prostatectomy took over 8 hours, now we can do 3 cases in a day and be done be 5 p.m.

In Thoracic, we use the robot for a lot of our VATS, from mediastinal node dissection to lobectomy to IVOR Lewis Esophagectomy.

Glad to see some posting action! How about sharing things you have learned. Take positioning for a robot prostate...what is you usual set-up? We use lithotomy with th patient ultimately placed in a very steep head down position. We have had some patient slipping problems if all things are not done exactly correctly. Some neuropathies have resulted. We pad the inside of the Yellofins with foam, strap them down and the put foam on the outside of the Yellofins to further protect the patient. We used to put foam on the bottom and the top of the legs inside the fins but ended up with some pressure problems especially as the patients have on SCDs. We use foam (eggcrate) under the right arm, a gel pad around the left arm and eggcrate on top of it. Both arms are tucked at the sides with the draw sheet. Eggcrate is placed under the sacrum as well This works most of the time however with morbidly obses patients we do have problems getting the positioning to work securely and without cutting off circulation to the arms. Any suggestions? How do you folks do it? What equipment do you use? Lessons learned? Thanks!!

nope, and I don't believe that we will be either. They should be available at major centers don't think I want every urologist that goes to a weekend program using one on me or my family. You need a surgeon that is already exceptional in laprascopic surgery applications too....................

Positioning for a prostatectomy is definitely a team effort. We usually use 5 pieces of eggcrate foam for each case. We completely wrap each arm with foam from axilla to 2-3 inches pass the fingers and secure it with 3 pieces of tape. We put a small piece behind each knee on top of the yellow fin, and a special cut one for the chest. The patient is also on a bean bag and after the foam is placed and secured, we use 2 rolls of tape to secure the patient to the bed.

Does anyone know of any devices specifically made for positioning for robots or any case where you want to keep the pt from slipping off the head of the bed? We currently put eggcrates aroudn the shoulders and one across the chest, then criss cross tape over the eggcrates to keep the pt in place. I'm thinking that there must be a better way. I know for lap banding, they have leg straps that keep the pt in place, so I was wondering if they had something made in a similar fashion that would work for the shoulders.

please share how your positioning is done.

We've got one ...

and get this.. a few weeks ago.. I couldn't figure out why a hysterectomy/BSO was on the schedule for 8 hours!!!!! You got it.. DaVinci!.. I was amazed!!!! I really wanted to meet the patient and ask her why the heck she agreed to an 8 hour robot surgery instead of a traditional open or even a vag hyst that would take.. oh .. 1/8th the time..

I'm not an OR nurse, but I work on the post-surgery floor. Our hospital has one and it is used for prostates and hysts; so far we've seen higher complications rates. Obviously our surgeons haven't had enough experience with it, and yet there are patients out there still willing sign up to be guinea pigs.