Chapter
2.2.2 Implementation phase (learning curve or initial robotic program)
3 Financial analysis of robotic surgery in gynecology
3.2 Cost of robotic surgery
3.3 Cost effectiveness of robotic surgery vs. laparoscopic and open approaches
3.4 Coverage of robotic surgery by health systems
3.5 How to use robotics more cost efficiently?
4 Training and credentialing in robotic gynecologic surgery and legal issues
4.2 Training and credentialing
4.3.1 Components of medical malpractice
4.3.2 Insufficient training and credentialing legal issues
4.3.3 Robotic proctors and legal issues
5 Patient positioning, trocar placement, and docking for robotic gynecologic procedures
5.2 Importance of proper patient positioning and trocar placement
5.3.1 Principles of patient positioning
6 Role of the robotic surgical assistant
6.1 The surgeon in the area of conflict between autonomy and dependency
6.2 Tasks of the robotic surgical assistant
6.2.1 Tasks of the robotic surgical assistant previous to the beginning of the surgical intervention
6.2.2 Tasks of the robotic surgical assistant between beginning of the surgery and start of the console phase
6.2.3 Tasks of the robotic surgical assistant during the console phase
6.2.4 Tasks of the robotic surgical assistant after termination of the console phase until the skin closure
6.3 Selection criteria of the robotic surgical assistant
6.4 Training/education of the robotic surgical assistant
6.4.1 Practical and virtual simulation/simulator systems
6.4.2 Training programs – request and reality
6.5 Aspects of spatial arrangement and structures of communication
6.6 Available data relating to the role of the robotic surgical assistant/existing evidence
7 Strategies for avoiding complications from robotic gynecologic surgery
7.2 Patient positioning – prevention of neurologic injuries
7.3 Complications of pneumoperitoneum and steep Trendelenburg
7.4.1 Electrosurgical principles
7.4.2 Monopolar electrosurgery
7.4.3 Bipolar electrosurgery
7.5 Avoiding surgical complications
7.5.1 Avoiding port complications
7.5.2 Gastrointestinal complications
7.6 Genitourinary complications
7.7 Complications of pelvic and para-aortic lymph node dissection
7.10 Vaginal cuff dehiscence
Part II: General gynecology
8 Robotically-assisted simple hysterectomy
8.1.2 Robotic hysterectomy vs. laparoscopy: surgical outcomes
8.2 Robot-assisted simple hysterectomy procedure
8.2.1 Positioning the patient
8.2.4 Instrument selection
8.2.5 Step-by-step approach to simple hysterectomy
8.2.6 New innovative techniques for robotic hysterectomy: robotic surgery to laparoendoscopic single-site surgery (R-LESS)
9 Approach to the big uterus for hysterectomy
9.2 How large is possible?
9.4 Creating the bladder flap
10 The difficult robotic hysterectomy
10.2 The scenarios of difficult and complex hysterectomy
10.3 Patients selection for robotic hysterectomy
10.4 Pre-operative preparation for a difficult hysterectomy
10.5 Technical operative factors and considerations
10.5.1 Anesthesia considerations
10.5.2 Following induction of anesthesia
10.5.3 Patient positioning
10.5.5 Uterine manipulation
10.5.8 Steps of robotic hysterectomy
10.6 General considerations
10.6.1 Choice of instruments
10.6.2 How to avoid trocar site hernia?
10.6.3 How to avoid losing pneumo peritoneum?
10.6.4 How to avoid vaginal cuff infection/dehiscence?
10.6.7 Continuing professional development
11 Robot-assisted laparoscopic myomectomy (RALM)
11.1 Principles of surgical therapy of uterine myomas
11.2 Patient selection for robot-assisted laparoscopic myomectomy (RALM)
11.3 Technical and logistic aspects of robot-assisted myomectomies
11.3.1 Patient positioning
11.3.3 Selection of robotic instruments (EndoWrist™ instruments)
11.3.4 Uterine manipulation
11.3.6 Operation schedule for RALM
11.3.7 Camera work (0° vs. 30° endoscope)
11.3.8 Features and characteristics of robot-assisted myomectomy
11.3.9 Suturing techniques and suture material
11.3.10 Adhesion prophylaxis
11.3.11 Intraabdominal asservation/storage of removed myomas
11.4 Advantages of robotic assistance concerning myomectomies
11.5 Disadvantages and deficiencies of robotic assistance concerning myomectomy
11.6 Preoperative preparations/perioperative management
11.6.1 Indications for robot-assisted myomectomy
11.6.2 Organ-specific diagnostics
11.6.3 Medicamentous pretreatment
11.6.4 Preparation of the surgery
11.6.5 Patient information and informed consent
11.7 Recommendations for further diagnostics and treatment/time interval to pregnancy/mode of delivery
11.9 Authors data of robot-assisted myomectomy
11.10 Available data from robot-assisted myomectomies/ existing evidence
11.11 Summary and conclusion
12 Endometriosis: robotic-assisted laparoscopic surgical approaches
12.2 Application to endometriosis
12.5 Peritoneal and tubo-ovarian endometriosis
12.6 Intestinal endometriosis
12.7 Genitourinary endometriosis
12.8 Diaphragmatic and thoracic endometriosis
12.9 Hepatic endometriosis
13 Robotic-assisted tubal reanastomosis
13.2.1 Positioning of the robotic surgical system
13.2.2 Robotic-assisted tubal reversal procedure
13.3 The surgical outcomes of robotic-assisted tubal reversal
14 Robotic-assisted abdominal cerclage
15 Single-port robotic surgery
Part III: Gynecologic onocology
16 Update on robotic surgery in the management of cervical cancer
16.2.1 Radical hysterectomy
16.2.2 Radical trachelectomy
16.3 Locally advanced disease
16.4 Incidental invasive cervical cancer: robotic-radical parametrectomy
17 Robotic-infrarenal aortic lymphadenectomy: A step-by-step approach
17.5 Transperitoneal techniques
17.5.1 Midline approach, pelvic trocars, no table rotation
17.5.2 Midline approach, pelvic trocars, 180° table rotation
17.5.3 Midline approach, subcostal trocars
17.5.4 Left lateral approach
17.6 Extraperitoneal technique
18 Robotic-pelvic and aortic lymphadenectomy for gynecologic malignancies – one approach
18.2 The rationale for lymphadenectomy
18.3 The minimally-invasive shift
18.4 Operating room set-up and patient preparation
18.5 Surgical technique for center-docked robotic-assisted aortic lymphadenectomy
18.6 Surgical technique for robotic-assisted pelvic lymphadenectomy
18.8 Managing obese patients with endometrial cancer
19 Robotic-extraperitoneal lymphadenectomy: A step-by-step approach
19.2 Robotic-assisted retroperitoneal laparoscopic para-aortic lymphadenectomy: Technique
19.2.2 Examination under anesthesia and cystoscopy
19.2.3 Position of patient
19.2.4 Diagnostic laparoscopy
19.2.5 Entering the extraperitoneal space with intraperitoneal laparoscopic guidance
19.2.6 Placement of balloon trocar and the formation of the retroperitoneal space
19.2.7 Placement of surgical trocars into the retroperitoneal space
19.2.8 Formation of the surgical plan at the retroperitoneal space
19.2.9 Left aortic and paracaval nodal dissection
19.2.10 Marsupialization of the retroperitoneal space
20 Robotic surgery for ovarian cancer
20.2 Benefits of minimally-invasive surgery
20.3 Low-malignant potential or borderline ovarian tumors
20.4 Early-stage invasive ovarian cancer
20.5 Advanced stage invasive ovarian cancer
21 Risk-reducing bilateral salpingo-oopherectomy in BRCA mutations career
21.2 Risk reducing strategies
21.3 Risk reducing salpingo-oopherectomy (RRSO)
21.5 Primary peritoneal carcinoma after RRSO
21.6 Occult cancer at the time of RRSO
21.7 Health proplems after RRSO
21.9 RRSO with/without hysterectomy
21.10 Radical fimbriectomy: As a new temporary risk reducing surgery
21.10.1 Laparoendoscopic single port surgery (LEES) for RRSO
21.11 Pathologic examination of tuba
21.12 Complication of RRSO
22 Robotic surgery for uterine cancer
22.4 Preoperative evaluation
22.7 Pneumoperitoneum, port placement, and instruments
22.9 Pelvic lymphadenectomy
22.10 Para-aortic lymphadenectomy
22.12 Extrafascial hysterectomy
22.13 Closure of the vaginal apex
23 Compartment-based radical surgery: The TMMR, FMMR and PMMR family in uterine cancer
23.2 Therapeutic pelvic and periaortic lymphadenectomy (rtLNE)
23.3 Total mesometrial resection (rTMMR)
23.4 Fertility preserving mesometrial resection (rFMMR)
23.5 Peritoneal mesometrial resection (rPMMR)
24 Robotic surgery for urogynecologic diseases
24.2 Robotic-vesicovaginal fistula repair
24.3 Robotic ureteral reconstructive surgery
24.4 Robot-assisted laparoscopic sacrocolpopexy (RALS)
25 Robotic sacrocolpopexy for the management of uterine and vaginal vault prolapse
25.2 Evaluation and surgical indications
25.3 Technique and concomitant procedure
25.3.1 Preoperative preparation
25.3.2 Patient positioning and initial preparation
25.3.3 Access and port placement
25.3.4 Surgical technique
25.3.6 Anterior dissection
25.3.7 Posterior dissection
25.4 Outcomes and complications
25.4.1 Anatomical and functional outcomes of RASC
26 Robotic-retropubic urethropexy
26.2 Midurethral sling versus robotic retropubic urethropexy
26.3 Evolution of the robotic Burch colposuspension
26.4 Step-by-step description of the robotic-assisted Burch colposuspension
26.4.1 Preoperative planning
26.4.2 Positioning the patient and Foley insertion
26.4.5 Concomitant procedures
26.4.6 Repositioning the patient
26.4.7 Retrograde filling of the bladder
26.4.8 Dissection to create the retropubic space of Retzius
26.4.9 Identification of urethro-vesicular junction (UVJ) using hand in the vagina
27 Pediatric gynecology for robotic surgery
27.2 Sling procedure for bladder outlet incompetence
27.2.1 Surgical technique
27.3.1 Surgical technique
27.4.1 Surgical technique
27.5 Surgical management of endometriosis
27.5.1 Surgical technique
28 Robotic-assisted surgery advances benefit patients
29 Gynecology-related general surgery
29.1 How do gastrointestinal injuries occur?
29.2 Management of the gastrointestinal injuries
29.2.2 Small bowel injuries
29.2.3 Large bowel injuries
29.3 Prevention of gastrointestinal injury
30 Ophthalmology and steep Trendelenburg
30.2 Posture-induced ocular changes
30.3 Post-operative ophthalmological complications
30.4 Ophthalmological patient management
30.4.1 Preoperative evaluation
30.4.2 Intraoperative period
30.4.3 Postoperative assessment
31 The future of telesurgery and new technology
31.2 Technical description
31.3 First preclinical studies
Robotic Surgery
：Practical Examples in Gynecology
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.
