Preface -- Acknowledgements -- Index of authors -- Part I: Basics -- 1 Robotic gynecologic surgery - introduction -- 1.1 History -- 1.2 Robotics systems -- 1.3 Endoscopic surgery in gynecology -- 1.4 The advantages of robotic surgery -- 1.5 Limitations of robotic surgery -- 1.6 Telemedicine and robotic surgery: future aspects -- 1.7 Final suggestions -- References -- 2 Launching a successful robotic program -- 2.1 Introduction -- 2.2 Phases of a successful robotic gynecologic program -- 2.2.1 Planning phase -- 2.2.2 Implementation phase (learning curve or initial robotic program) -- 2.2.3 Evolving program -- 2.3 Academic activities -- 2.3.1 Education -- 2.3.2 Research -- 2.4 Financial analysis -- 2.5 Conclusion -- References -- 3 Financial analysis of robotic surgery in gynecology -- 3.1 Introduction -- 3.2 Cost of robotic surgery -- 3.3 Cost effectiveness of robotic surgery vs. laparoscopic and open approaches -- 3.4 Coverage of robotic surgery by health systems -- 3.5 How to use robotics more cost efficiently? -- 3.6 Conclusion -- References -- 4 Training and credentialing in robotic gynecologic surgery and legal issues -- 4.1 Introduction -- 4.2 Training and credentialing -- 4.2.1 Training -- 4.2.2 Credentialing -- 4.3 Legal issues -- 4.3.1 Components of medical malpractice -- 4.3.2 Insufficient training and credentialing legal issues -- 4.3.3 Robotic proctors and legal issues -- 4.4 Conclusion -- References -- 5 Patient positioning, trocar placement, and docking for robotic gynecologic procedures -- 5.1 Introduction -- 5.2 Importance of proper patient positioning and trocar placement -- 5.3 Patient positioning -- 5.3.1 Principles of patient positioning -- 5.4 Trocar placement -- 5.4.1 Peritoneal access -- 5.4.2 Trocar placement -- 5.5 Initial survey -- 5.6 Docking -- 5.6.1 Docking types -- 5.7 Conclusion -- References.

6 Role of the robotic surgical assistant -- 6.1 The surgeon in the area of conflict between autonomy and dependency -- 6.2 Tasks of the robotic surgical assistant -- 6.2.1 Tasks of the robotic surgical assistant previous to the beginning of the surgical intervention -- 6.2.2 Tasks of the robotic surgical assistant between beginning of the surgery and start of the console phase -- 6.2.3 Tasks of the robotic surgical assistant during the console phase -- 6.2.4 Tasks of the robotic surgical assistant after termination of the console phase until the skin closure -- 6.3 Selection criteria of the robotic surgical assistant -- 6.4 Training/education of the robotic surgical assistant -- 6.4.1 Practical and virtual simulation/simulator systems -- 6.4.2 Training programs - request and reality -- 6.5 Aspects of spatial arrangement and structures of communication -- 6.6 Available data relating to the role of the robotic surgical assistant/existing evidence -- 6.7 Conclusions -- References -- 7 Strategies for avoiding complications from robotic gynecologic surgery -- 7.1 Introduction -- 7.2 Patient positioning - prevention of neurologic injuries -- 7.3 Complications of pneumoperitoneum and steep Trendelenburg -- 7.4 Robotic equipment -- 7.4.1 Electrosurgical principles -- 7.4.2 Monopolar electrosurgery -- 7.4.3 Bipolar electrosurgery -- 7.5 Avoiding surgical complications -- 7.5.1 Avoiding port complications -- 7.5.2 Gastrointestinal complications -- 7.6 Genitourinary complications -- 7.6.1 Bladder -- 7.6.2 Ureter -- 7.7 Complications of pelvic and para-aortic lymph node dissection -- 7.8 Incisional hernia -- 7.9 Vascular injuries -- 7.10 Vaginal cuff dehiscence -- 7.11 Summary -- References -- Part II: General gynecology -- 8 Robotically-assisted simple hysterectomy -- 8.1 Introduction -- 8.1.1 Background.

8.1.2 Robotic hysterectomy vs. laparoscopy: surgical outcomes -- 8.1.3 Cost analysis -- 8.2 Robot-assisted simple hysterectomy procedure -- 8.2.1 Positioning the patient -- 8.2.2 Trocar placement -- 8.2.3 Docking -- 8.2.4 Instrument selection -- 8.2.5 Step-by-step approach to simple hysterectomy -- 8.2.6 New innovative techniques for robotic hysterectomy: robotic surgery to laparoendoscopic single-site surgery (R-LESS) -- 8.3 Comment -- References -- 9 Approach to the big uterus for hysterectomy -- 9.1 Introduction -- 9.2 How large is possible? -- 9.3 Technique -- 9.4 Creating the bladder flap -- 9.5 Approach to vessels -- 9.6 Making the colpotomy -- 9.7 Tissue removal -- References -- 10 The difficult robotic hysterectomy -- 10.1 Introduction -- 10.2 The scenarios of difficult and complex hysterectomy -- 10.3 Patients selection for robotic hysterectomy -- 10.4 Pre-operative preparation for a difficult hysterectomy -- 10.5 Technical operative factors and considerations -- 10.5.1 Anesthesia considerations -- 10.5.2 Following induction of anesthesia -- 10.5.3 Patient positioning -- 10.5.4 Entry -- 10.5.5 Uterine manipulation -- 10.5.6 Trocar placement -- 10.5.7 Docking -- 10.5.8 Steps of robotic hysterectomy -- 10.6 General considerations -- 10.6.1 Choice of instruments -- 10.6.2 How to avoid trocar site hernia? -- 10.6.3 How to avoid losing pneumo peritoneum? -- 10.6.4 How to avoid vaginal cuff infection/dehiscence? -- 10.6.5 Data collection -- 10.6.6 Learning curve -- 10.6.7 Continuing professional development -- References -- 11 Robot-assisted laparoscopic myomectomy (RALM) -- 11.1 Principles of surgical therapy of uterine myomas -- 11.2 Patient selection for robot-assisted laparoscopic myomectomy (RALM) -- 11.3 Technical and logistic aspects of robot-assisted myomectomies -- 11.3.1 Patient positioning -- 11.3.2 Equipment.

11.3.3 Selection of robotic instruments (EndoWrist™ instruments) -- 11.3.4 Uterine manipulation -- 11.3.5 Trocar placement -- 11.3.6 Operation schedule for RALM -- 11.3.7 Camera work (0° vs. 30° endoscope) -- 11.3.8 Features and characteristics of robot-assisted myomectomy -- 11.3.9 Suturing techniques and suture material -- 11.3.10 Adhesion prophylaxis -- 11.3.11 Intraabdominal asservation/storage of removed myomas -- 11.4 Advantages of robotic assistance concerning myomectomies -- 11.5 Disadvantages and deficiencies of robotic assistance concerning myomectomy -- 11.6 Preoperative preparations/perioperative management -- 11.6.1 Indications for robot-assisted myomectomy -- 11.6.2 Organ-specific diagnostics -- 11.6.3 Medicamentous pretreatment -- 11.6.4 Preparation of the surgery -- 11.6.5 Patient information and informed consent -- 11.7 Recommendations for further diagnostics and treatment/time interval to pregnancy/mode of delivery -- 11.8 Case studies -- 11.9 Authors data of robot-assisted myomectomy -- 11.10 Available data from robot-assisted myomectomies/ existing evidence -- 11.11 Summary and conclusion -- References -- 12 Endometriosis: robotic-assisted laparoscopic surgical approaches -- 12.1 Introduction -- 12.2 Application to endometriosis -- 12.3 Surgical approach -- 12.4 Lysis of adhesions -- 12.5 Peritoneal and tubo-ovarian endometriosis -- 12.6 Intestinal endometriosis -- 12.7 Genitourinary endometriosis -- 12.8 Diaphragmatic and thoracic endometriosis -- 12.9 Hepatic endometriosis -- 12.10 Conclusion -- References -- 13 Robotic-assisted tubal reanastomosis -- 13.1 Introduction -- 13.2 Surgical technique -- 13.2.1 Positioning of the robotic surgical system -- 13.2.2 Robotic-assisted tubal reversal procedure -- 13.3 The surgical outcomes of robotic-assisted tubal reversal -- References.

14 Robotic-assisted abdominal cerclage -- 14.1 Introduction -- 14.2 Operative technique -- 14.3 Outcomes -- References -- 15 Single-port robotic surgery -- 15.1 Introduction -- 15.2 Surgical technique -- 15.3 Discussion -- 15.4 Conclusion -- References -- Part III: Gynecologic onocology -- 16 Update on robotic surgery in the management of cervical cancer -- 16.1 Introduction -- 16.2 Early-stage disease -- 16.2.1 Radical hysterectomy -- 16.2.2 Radical trachelectomy -- 16.3 Locally advanced disease -- 16.4 Incidental invasive cervical cancer: robotic-radical parametrectomy -- 16.5 Conclusions -- References -- 17 Robotic-infrarenal aortic lymphadenectomy: A step-by-step approach -- 17.1 Introduction -- 17.2 Patient selection -- 17.3 Advantages -- 17.4 Approaches -- 17.5 Transperitoneal techniques -- 17.5.1 Midline approach, pelvic trocars, no table rotation -- 17.5.2 Midline approach, pelvic trocars, 180° table rotation -- 17.5.3 Midline approach, subcostal trocars -- 17.5.4 Left lateral approach -- 17.6 Extraperitoneal technique -- 17.7 Conclusion -- References -- 18 Robotic-pelvic and aortic lymphadenectomy for gynecologic malignancies - one approach -- 18.1 Introduction -- 18.2 The rationale for lymphadenectomy -- 18.3 The minimally-invasive shift -- 18.4 Operating room set-up and patient preparation -- 18.5 Surgical technique for center-docked robotic-assisted aortic lymphadenectomy -- 18.6 Surgical technique for robotic-assisted pelvic lymphadenectomy -- 18.7 Comparative studies -- 18.8 Managing obese patients with endometrial cancer -- 18.9 Future directions -- 18.10 Conclusions -- References -- 19 Robotic-extraperitoneal lymphadenectomy: A step-by-step approach -- 19.1 Introduction.

19.2 Robotic-assisted retroperitoneal laparoscopic para-aortic lymphadenectomy: Technique.