can't consider that an insignificant number.
When robots started becoming popular, 10
or so years ago, the first operations were
relatively short prostatectomies, which
require steep Trendelenburg. But as gyne-
cologists followed the lead of urologists and
began doing longer and more complex sur-
geries in the steep position, they didn't
always consider the kinds of complications
that might develop, and a lot of lawsuits fol-
lowed. Still, however, I'd guess that about
80% of the time, the tendency is to automat-
ically go to steep Trendelenburg.
8. Know what you're asking for. Some tables
can only tilt 25 degrees, while others may go
to 40. A surgeon who isn't aware, or paying
attention, may ask for maximum
Trendelenburg, potentially putting the patient
at 40 degrees, when 25 was all he really want-
ed or needed. Remember, the steeper the tilt,
the more potential there is for complications.
9. Don't use straps and harnesses. These are
muscle and pressure point injuries — or
worse — waiting to happen. And the steeper
the tilt, the more pressure there is.
Remember, if you're operating on a 300-pound
patient, roughly 50% of that weight is being
shifted to the upper back, and that can cause
M A R C H 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 7 7
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