A simple technique to improve docking time in robotic surgery

The docking process is a crucial step in robotic surgery, which determines the technical capability of moving the robotic arms during surgery and affects the performance of surgery. Robotic companies, therefore, provide setup guides recommending the trocar placement, arm carts, and operating table positioning for each procedure or body quadrant, to facilitate this process. This process takes time and although improves with experience, reported docking times range from 4 to 29 min. The final step of docking the robot is sometimes challenging and includes the insertion of the robotic instruments into the surgical field which involve patient safety. We implemented a simple new technique for safe insertion of robotic instruments and overcome the challenge of manipulating the camera arm for visualizing the trocars and advancing of the robotic instruments into the surgical field. This technique utilizes simple laparoscopic skills of laparoscopic instrument insertion. Docking times were recorded in ten consecutive patients undergoing robotic surgeries with the Hugo RAS™ and compared to our prospectively collected data registry prior to this technique. The new technique reduced the average docking time by 3.5 min and resulted in improvement of 45% in docking time. Integrating trivial laparoscopic skills into the docking process may simplify and reduce the docking time in robotic surgery.