Port Placement

Preparing for Port Placement

da Vinci® Endoscope Port, 12 mm (Blue): Place port 3-4cm right and 3-4 cm above umbilicus. Distance to symphysis pubis should be ~22-24 cm.
Right da Vinci Instrument Port, 8 mm (Yellow): Place a minimum of 8 cm from the endoscope port, on the right spinoumbilical line (SUL) at the crossing of the mid-clavicular line (MCL). Distance to symphysis pubis should be ~14-16 cm.
Left da Vinci Instrument Port, 8 mm (Green): Place ~6 cm lateral of the left MCL about 3-4 cm cephalad to the SUL. Distance to symphysis pubis should be ~16-18 cm.
3rd da Vinci Instrument Port, 8 mm (Red): Place 3-4 cm subxyphoid halfway between right MCL and midline.
4th da Vinci Instrument Port, 8 mm (Green-Red): Place 7-8 cm below left costal margin, slightly medial to the left MCL. Distance to other instrument ports and the endoscope port should be at least 8-10 cm.
Assistant Port (A1), 5 mm (White): Place port 8-10 cm cephalad to the right instrument port and a minimum of 8 cm from the endoscope port. This port is used for suction/irrigation, ligation and retraction.

Port & Arm Setup per Procedure Step

The da Vinci Low Anterior Resection procedure is performed in the following sequence and set-up [Figures 4a-c]:

For the initial phase of the procedure (steps 1-3), which focuses on the patient’s left side, the da Vinci System is used in a 4-arm set-up with instrument arms 1, 2 and 3 docked.
Splenic flexure mobilization (step 4) is performed with the da Vinci System in a 3-arm set-up with only instrument arms 1 and 3 docked to minimize external collisions.
Once the dissection proceeds distally of the sacral promontory into the pelvis, instrument arms 2 and 3 are re-docked in the lower and upper left da Vinci instrument ports and the remaining steps 5-6 are performed in a 4-arm set-up again.

[ Figures 4a-c - Enlarge ]

Next: Docking