Using the "Summa Set-up" in robotic assisted gynecologic surgery.

During challenging gynecologic (GYN) procedures, the conventional robotic set-up can limit a surgeon's ability to effectively and efficiently perform these procedures. We present a novel set-up using a parallel-docking approach of the da Vinci (®) Surgical System with only three robotic arms and incorporating two patient side assist ports to overcome the difficulties presented during challenging GYN procedures. The Summa Set-up (SS) uses 4 ports actively, 2 assist ports and 2 robotic ports, compared to the traditional set-up which uses 4 ports: 1 assist port and 3 robotic ports. With the SS format, the patient-side assistant stands at the head of the bed and can simultaneously retract the uterus and aide in surgical dissection along with the console surgeon. While there are many possibilities of da Vinci (®) docking, port placement and assistant placement during robotic-assisted GYN surgery, we believe the SS can be an alternative for many GYN surgeons, especially those in teaching hospitals, for increased mobility and efficiency during complex GYN procedures.