Complications of port placement

Abstract

Port placement represents the cornerstone of minimally invasive surgery procedures; an improper placement translates into difficulties leading to an extension of the operating time and sometimes requiring reposition of the trocars. As in laparoscopic surgery, there are complications in robotic surgery also when placing a port; carrying out a proper training and performing an adequate learning curve have shown a significant decrease in the rate of complications at this important phase. At the first step of surgery, pneumoperitoneum creation and primary trocar placement, is where the largest number of unwanted events occur. There are several techniques, which have proven to be equally effective, with similar rates of complications; therefore, the surgeon should use the method that s/he has more experience with and the one s/he feels more comfortable with. It is always important to individualize each case, to identify risk factors, and to choose the ideal techniques and instruments for prevention. In robotic surgery, there are special considerations regarding port placement, this allows a proper docking, avoiding a clash of the robot arms. Undoubtedly, no surgeon is free of complications, but an early diagnosis is crucial to resolve them timely and effectively, reducing this way the morbidity and mortality rate. Abdominal access and proper port placement without complications are key to the success of robotic surgery. When complications do occur, an excellent training will allow them to be managed appropriately.