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Relationship Between Race and Abdominal Anatomy: Effect on Robotic Port Placement

Parnell, Brent A. MD*; Midia, Esin C. MD; Fielding, Julia R. MD; Robinson, Barbara L. MD*; Matthews, Catherine A. MD*

Female Pelvic Medicine & Reconstructive Surgery: May/June 2013 - Volume 19 - Issue 3 - p 165–168
doi: 10.1097/SPV.0b013e318288ad6d
Original Articles

Objectives We sought to characterize differences between African American women and white women in abdominal wall dimensions that could affect robotic port placement. By better understanding these differences, surgeons could assess and adjust port placement to accommodate varying abdominal wall anatomy.

Methods A radiologist blinded to race-reviewed abdominal/pelvic computed tomographic scans of women aged 30 to 70 prescreened for demographic inclusion criteria. These consecutive scans were screened for radiologic exclusion criteria until 40 consecutive scans from each race were identified and included.

Results Eighty of 663 patients, 40 of each race, met demographic inclusion criteria. The most common radiologic feature disqualifying the scans included absence of the xiphoid process on the scan and anterior abdominal wall deformity. Demographic variables including age, weight, height, and body mass index were similar between groups. Symphysis pubis to umbilicus measurement was shorter in the African American group (15.7 [2.1] vs 17.1 [2.0]; P < 0.001) and intra–anterior superior iliac spine distance was narrower (21.4 [1.2] vs 23.8 [2.0]; P = 0.003), creating an overall smaller lower abdomen in African American women. Total abdominal length was the same between groups (36.6 [2.6] vs 36.7 [2.8]; P = 0.851). Using linear regression, height, weight, and body mass index did not affect lower abdominal dimensions, whereas age (P < 0.001) had a significant inverse relationship with the symphysis pubis to umbilicus measurement.

Conclusions Lower abdominal dimensions between races vary, with the umbilicus serving as an inconsistent landmark. Variance exists that can be attributed to racial differences. Assessment of these dimensions at the time of robotic surgery could lead to improved port spacing and therefore fewer arm collisions, improving robotic efficiency.

Lower abdominal dimensions vary between races. Assessing these dimensions can affect robotic port placement

From the *Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology; and †Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Reprints: Brent A. Parnell, MD, 1120 15th St, BB-7518A, Augusta, GA 30912. E-mail:

These findings were presented as a poster at the 38th Annual Society of Gynecologic Surgeons Scientific Meeting, April 13–15, 2012 in Baltimore, Maryland.

Dr. Catherine Matthews is on the Speakers’ Bureau for Intuitive Surgical, Inc and has accepted honoraria. The remaining authors have declared that they have no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins