The advent of robotic surgery brought a rise in the proportion of minimally invasive surgery in gynecology. This book provides a practical guide to this innovative field. First it introduces the basics of robotic surgery and then focuses on specific gynecology-related surgeries. Gynecologists currently practicing robotic surgery as well as those who would like to include robotic surgery in their practice will benefit greatly from this book.

1;Preface ;5 2;Acknowledgements;7 3;Index of authors;9 4;Part I: Basics;29 4.1;1 Robotic gynecologic surgery - introduction;31 4.1.1;1.1 History;31 4.1.2;1.2 Robotics systems;32 4.1.3;1.3 Endoscopic surgery in gynecology;35 4.1.4;1.4 The advantages of robotic surgery;37 4.1.5;1.5 Limitations of robotic surgery;37 4.1.6;1.6 Telemedicine and robotic surgery: future aspects;37 4.1.7;1.7 Final suggestions;38 4.1.8;References;38 4.2;2 Launching a successful robotic program;41 4.2.1;2.1 Introduction;41 4.2.2;2.2 Phases of a successful robotic gynecologic program;41 4.2.2.1;2.2.1 Planning phase;41 4.2.2.2;2.2.2 Implementation phase (learning curve or initial robotic program);46 4.2.2.3;2.2.3 Evolving program;46 4.2.3;2.3 Academic activities;48 4.2.3.1;2.3.1 Education;48 4.2.3.2;2.3.2 Research;49 4.2.4;2.4 Financial analysis;49 4.2.5;2.5 Conclusion;50 4.2.6;References;50 4.3;3 Financial analysis of robotic surgery in gynecology;51 4.3.1;3.1 Introduction;51 4.3.2;3.2 Cost of robotic surgery;51 4.3.3;3.3 Cost effectiveness of robotic surgery vs. laparoscopic and open approaches;52 4.3.4;3.4 Coverage of robotic surgery by health systems;55 4.3.5;3.5 How to use robotics more cost efficiently?;56 4.3.6;3.6 Conclusion;56 4.3.7;References;56 4.4;4 Training and credentialing in robotic gynecologic surgery and legal issues;59 4.4.1;4.1 Introduction;59 4.4.2;4.2 Training and credentialing;59 4.4.2.1;4.2.1 Training;59 4.4.2.2;4.2.2 Credentialing;60 4.4.3;4.3 Legal issues;61 4.4.3.1;4.3.1 Components of medical malpractice;61 4.4.3.2;4.3.2 Insufficient training and credentialing legal issues;61 4.4.3.3;4.3.3 Robotic proctors and legal issues;62 4.4.4;4.4 Conclusion;63 4.4.5;References;63 4.5;5 Patient positioning, trocar placement, and docking for robotic gynecologic procedures;65 4.5.1;5.1 Introduction;65 4.5.2;5.2 Importance of proper patient positioning and trocar placement;65 4.5.3;5.3 Patient positioning;66 4.5.3.1;5.3.1 Principles of patient positioning;66 4.5.4;5.4 Trocar placement;69 4.5.4.1;5.4.1 Peritoneal access;69 4.5.4.2;5.4.2 Trocar placement;69 4.5.5;5.5 Initial survey;73 4.5.6;5.6 Docking;73 4.5.6.1;5.6.1 Docking types;74 4.5.7;5.7 Conclusion;74 4.5.8;References;75 4.6;6 Role of the robotic surgical assistant;77 4.6.1;6.1 The surgeon in the area of conflict between autonomy and dependency;77 4.6.2;6.2 Tasks of the robotic surgical assistant;78 4.6.2.1;6.2.1 Tasks of the robotic surgical assistant previous to the beginning of the surgical intervention;78 4.6.2.2;6.2.2 Tasks of the robotic surgical assistant between beginning of the surgery and start of the console phase;80 4.6.2.3;6.2.3 Tasks of the robotic surgical assistant during the console phase;80 4.6.2.4;6.2.4 Tasks of the robotic surgical assistant after termination of the console phase until the skin closure;83 4.6.3;6.3 Selection criteria of the robotic surgical assistant;83 4.6.4;6.4 Training/education of the robotic surgical assistant;84 4.6.4.1;6.4.1 Practical and virtual simulation/simulator systems;85 4.6.4.2;6.4.2 Training programs - request and reality;86 4.6.5;6.5 Aspects of spatial arrangement and structures of communication;87 4.6.6;6.6 Available data relating to the role of the robotic surgical assistant/existing evidence;90 4.6.7;6.7 Conclusions;91 4.6.8;References;92 4.7;7 Strategies for avoiding complications from robotic gynecologic surgery;95 4.7.1;7.1 Introduction;95 4.7.2;7.2 Patient positioning - prevention of neurologic injuries;96 4.7.3;7.3 Complications of pneumoperitoneum and steep Trendelenburg;98 4.7.4;7.4 Robotic equipment;99 4.7.4.1;7.4.1 Electrosurgical principles;99 4.7.4.2;7.4.2 Monopolar electrosurgery;99 4.7.4.3;7.4.3 Bipolar electrosurgery;101 4.7.5;7.5 Avoiding surgical complications;101 4.7.5.1;7.5.1 Avoiding port complications;102 4.7.5.2;7.5.2 Gastrointestinal complications;103 4.7.6;7.6 Genitourinary complications;104 4.7.6.1;7.6.1 Bladder;104 4.7.6.2;7.6.2 Ureter;105 4.7.7;7.7 Complications of pelvic and para-aortic lymph node dissect