Upper extremity contact pressure measurement in robot-assisted pelvic surgery.

Journal: Journal of robotic surgery
PMID:

Abstract

Upper extremity complications are often a problem in robot-assisted pelvic surgery (RAPS) with the lithotomy-Trendelenburg position (LT-position). This study focused on upper extremity contact pressure (UEP) and examined the relationship between UEP and upper extremity complications. From May 2020 to April 2022 at the University of Tokyo Hospital, UEP was measured in 155 patients undergoing RARP and 20 patients undergoing RARC. A total of 350 sets of UEP were investigated in this study. UEP was measured using a portable interface pressure sensor (Palm Q, Cape CO., Kanagawa, Japan) in the preoperative lithotripsy position (L-position), preoperative LT-position, and postoperative L-position. UEP was increased in the preoperative LT-position than in the preoperative L-position (right side 5.2 mmHg vs. 17.1 mmHg, left side 5.3 mmHg vs. 17.1 mmHg, P < 0.001, respectively), and was decreased in the postoperative L-position than in preoperative LT-position (right side 17.1 mmHg vs. 10.8 mmHg, left side 17.1 mmHg vs. 10.6 mmHg, P < 0.001, respectively). Eleven upper extremities developed shoulder pain. UEP of the preoperative LT-position tended to be higher in the upper extremity exhibiting shoulder pain (25.6 mmHg (15.4-30.3) vs. 17.1 mmHg (12.0-24.4) P = 0.0901). UEP measurements may help prevent postoperative shoulder pain.

Authors

  • Naoki Kimura
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Yuta Yamada
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo, Japan.
  • Yuji Hakozaki
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Jun Kaneko
  • Jun Kamei
    Department of Urology, Jichi Medical University, Tochigi, Japan.
  • Satoru Taguchi
    Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan.
  • Yoshiyuki Akiyama
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Daisuke Yamada
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Tetsuya Fujimura
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo, Japan. fujimurat-uro@h.u-tokyo.ac.jp.
  • Haruki Kume
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo, Japan.