I recently had a patient who had muscle breakdown (rhabdomyolysis) of a buttock muscle after a robotic removal of part of a kidney for tumor.
I found a nice review of this problem on urotoday’s site that had an article from the BJU. The urologist that wrote the article were from the Department of Urology, Aberdeen Royal Infirmary in Aberdeen, UK.
My patient was overweight, but not morbidly obese. I performed the robotic partial nephrectomy in a similar lateral position that the authors show. He needed 1 course of dialysis when his kidneys were not working well. The rhabdomyolysis led to significantly kidney problems since our surgery is done by temporarily stopping the blood supply to the kidney which leads to short term kidney malfunction in that kidney. He also had kidney problems to start with.
I had performed over 40 robotic kidney surgeries in this positioning and over 150 laparoscopic ones prior to having this problem. There have also been reports of rhabdomyolysis after open surgery, but this rare complication should always be remembered even in experienced hands.