Robotic General Surgery

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SECTION 2 • Discipline-Based Practice - Hepatobiliary and Pancreatic Surgery

Console surgeon

Robotic tower

Laparoscopic tower

First assistant

Scrub technician

Anesthesiologist

B

A

FIGURE 21.2 Operating room setup including anterior positioning for the da Vinci© Xi robot, assistants, staff, and other personnel. Principles include (1) assistant between legs or on the lower side of the patient to allow for ergonomic access to the right upper quadrant; (2) nurse/scrub tech opposite of the robot to allow for ergonomic access to ports and equipment; (3) surgeon on the same side as bed side assistant and access to patient if possible; (4) monitor placement to allow assistant, anesthesiologist, and tech to see internal view. Schematic is shown in (A), and photograph in (B).

Pancreaticojejunostomy

Hepaticojejunostomy

Pancreaticojejunostomy

Hepaticojejunostomy

Gallbladder

Common bile duct

A FIGURE 21.3 Pancreaticoduodenectomy. Anatomic area to be resected is highlighted in light blue in (A). B, shows the typical reconstruc tion on a single jejunal loop, including the pancreaticojejunostomy, the hepaticojejunostomy, and the gastrojejunostomy. C, illustrates a pylorus sparing pancreaticoduodenectomy. Copyright © Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 2024 B C Tumor Gastrojejunostomy Gastrojejunostomy