Once pneumoperitoneum has been established, robotic port placement can begin. We typically use pneumoperitoneum pressures of 15mm Hg, but after docking can consider decreasing the pressure if the abdominal domain will allow as this allows for easier defect closure and atter prosthetic placement. If pneumoperitoneum is decreased during the case, remote centers should be reconrmed as this can affect the depth of the trocars. Under direct visualization using the 5mm laparoscopic trocar, two robotic ports are placed. The middle 8mm port will be for the camera and should be as lateral as possible to allow more room for the working ports. Ideally, this port is approximately 15cm from the hernia defect to facilitate visual­ization and dissection of the edge of the defect closest to the ports. In the lower quadrant, another 8mm robotic trocar is placed slightly more medial to the camera port and superior to the iliac crest. This port should be assessed for potential conict with the patient’s thigh prior to starting the operation. If the trocar at Palmer’s point can be used for the surgery, the port should be upsized to an 8mm robotic trocar. If not, a third robotic 8mm trocar should be placed cranial and just medial to the cam­era port. The three ports along the lateral abdomen should be in an arc and approxi­mately 8cm apart from one another. Care is taken during port placement to mentally visualize the arcs of the surgical arms and to anticipate arm conicts which will be most apparent at the extreme ends of the proposed peritoneal ap closure. If the ports are placed too medial, the ap creation and subsequent closure will be more difcult. Facile bedside support familiar with robotic ergonomics and adjustment of robotic arms can also avoid signicant frustration and difculties during the case.