Port placement. An 8-mm robotic trocar is placed at the left lateral costal margin, in which a 5-mm atraumatic grasper is used as the robotic assistant. Second, a left 8-mm port for the harmonic device is placed at the midclavicular line, 1 to 2 cm below the costal margin. Third, a 5-mm port is placed in the right lateral subcostal margin for the liver retractor and a robotic 8-mm trocar is placed in the right upper quadrant at the level of the midclavicular region, for the bipolar fenestrated grasper. Last, a 12-mm assistant port is placed in the right periumbilical umbilical region. (From Karush J, Sarkaria IS. Robotic-assisted giant paraesophageal hernia repair and Nissen fundoplication. Oper Tech Thorac Cardiovasc Surg. 2013;18(3):206; with permission.)