Positioning in pelvic robotic surgery and its repercussions on patient safety

Objectives: To describe the positions used in robotic pelvic surgery, observe the impact of these positions on patient safety and evaluate precautions for the patient's surgical positioning during the intraoperative period. Methods: A Systematic Literature Review (RSL) was carried out over the last 5 years. Results: 184 articles were located, of which 13 were selected according to PRISMA recommendations. Result: It was found that the main type of positioning used in robotic surgeries of the pelvic region is the trendelenburg associated with the lithotomy position, in addition to the pneumopritoneus. The main complications are: bradycardia, thromboembolisms, increased ocular, intra-abdominal and intra-thoracic pressure, neuropraxia, compartment syndrome, increased ICP, facial edema, injuries to pressure points. Prevention measures include the use of special anti-skid padding and mattresses, buttock padding, adequate positioning of the limbs. The use of fastening straps is recommended to avoid the risk of slips and falls and repositioning to the supine position for 10 minutes every 3 hours.