Patients Position and Operating Room Setup

The patient lies supine on the OR table, with legs lying flat and initially closed. The terminal part of the OR table must allow for the patient's legs to be opened to perform the anastomosis at the end of the operation. If a Miles procedure or a handsewn, pull-through anastomosis are planned, the legs are subsequently positioned on Allen stirrups, but are initially laid flat to avoid any interference with the surgeon's hands and instruments during the procedure, flexing the legs later, when the perineal part of the operation is over. Both arms are tucked.

During the procedure, patients are placed in a steep Trendelemburg position and rotated to the right, so they must be carefully secured to the bed with bilateral shoulder braces, with one brace positioned on a level with the right deltoid to prevent them from sliding when the table is tilted. Braces are wrapped with

Fig. 2. Robotic arms gel or foam cushions. To avoid nerve stretching, the position must be checked before anaesthesia is induced, with the patient still cooperative.

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