Abstract

Assisted robot surgery is a relatively new surgery as a procedure in our country. However, the procedures around the world are many especially in the first world where the experience is already great. The indications for performing this procedure have been extended, in terms of surgical specialties that can perform it, as well as the type of patient. Initially used in urological surgery, currently the assisted robot procedure is being used in minimally invasive thoracic surgery, oncological surgery and general surgery. It is therefore important to know the changes that these procedures cause in the anesthetized patient in order to successfully conduct the surgical anesthetic procedure. In the following article we present a case of assisted robot urological surgery (radical prostatectomy) and we review the anesthetic considerations for this type of procedures.

Keywords: Pneumoperitoneum; Deep Trendelemburg; Volume-Controlled Ventilation; Pressure-Controlled Ventilation

References

1. Schuessler Ww., et al. “Laparoscopic radical prostatectomy: initial Short-term experience”. Urology 50 (1997): 854-857.
2. Guillonneau B., et al. “Laparoscopic radical prostatectomy. Preliminary evaluation after 28 interventions”. Presse Médicale 27 (1998): 1570-1574.
3. Schiff J., et al. “Robotic microsurgical vasovasostomy and vasoepididymostomy: a prospective randomized study in a rat model”. The Journal of Urology171 (2004): 1720-1725.
4. Fleming C. “Robot-assisted vasovasostomy”. Urologic Clinics of North America 31 (2004): 769-772.
5. Oksar M., et al. “Prostatectomía robótica: análisis anestesiológico de cirugías urológicas robóticas, un estudio prospectivo”. Brazilian Journal of Anesthesiology (Edición en Español)5 (2014): 307-313.
6. Hsu RL., et al. “Anesthetic Challenges in Robotic-assisted Urologic Surgery”. Reviews in Urology4 (2013): 178-184.
7. Goswami S., et al. “Anesthesia for robotic surgery”. In: Miller RD, ed. Miller’s Anesthesia. 7th ed. Philadelphia, PA: Elsevier 1103 (2010): 2389-2395.
8. Thompson J. “Myocardial infarction and subsequent death in a patient undergoing robotic prostatectomy”. AANA Journal 77 (2009): 365-371.
9. Ashrafian H., et al. “The evolution of robotic surgery: Surgical and anaesthetic aspects”. British Journal of Anaesthesia 119 (2017): i72-i84.
10. Novara G., et al. “Sistematic Review and Metanalysis of Perioperative Outcomes and complication after Robot Assisted Radical Prostatectomy”. European Urology 3 (2012): 431-452.
11. Chang CH., et al. “The displacement of the tracheal tube during robot-assisted radical prostatectomy”. European Journal of Anaesthesiology 27 (2010): 478-480.
12. Suh MK., et al. “The effect of pneumoperitoneum and Trendelenburg position on respiratory mechanics during pelviscopic surgery”. Korean Journal of Anesthesiology 59 (2010): 329-334.
13. Tomescu DR., et al. “Obesity is Associated with decreased lung compliance and hypercapnia during robotic assisted surgery”. Journal of Clinical Monitoring and Computing 31 (2017): 85-92.
14. Thomsen LP., et al. “Non-invasive estimation of respiratory depression profiles during robot-assisted laparoscopic surgery using a model-based approach”. In CMBEBIH (2017): 223-231.
15. Rusca M., et al. “Prevention of atelectasis formation during induction of general anesthesia”. Anesthesia and Analgesia 97 (2003): 1835-1839.
16. Lee HJ., et al. “Optimal positive end-expiratory pressure during robot-assisted laparoscopic radical prostatectomy”. Korean Journal of Anesthesiology 65 (2013): 244-250.
17. Irvine M and Patil V. “Anaesthesia for robot-assisted laparoscopic surgery”. Continuing Education in Anaesthesia, Critical Care and Pain 9 (2009): 125-129.
18. Jaju R., et al. “Comparison of volume-controlled ventilation and pressure-controlled ventilation in patients undergoing robot assisted pelvic surgeries: An open label trial”. Indian Journal of Anaesthesia 61 1 (2017): 27-33.
19. Min-Soo Kim., et al. “The impact of two different inspiratory to expiratory ratios (1:1 and 1:2) on respiratory mechanics and oxygenation during volume-controlled ventilation in robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial”. Canadian Journal of Anesthesia 62 (2015): 979-987.
20. Saloni Paranjape and Anjolie Chhabra. “Anaesthesia for robotic surgery”. Trends in Anaesthesia and Critical Care 4 (2014): 25e31.
21. Hong JY., et al. “Effects of thoracic epidural analgesia combined with general anesthesia on intraoperative ventilation/oxygenation and postoperative pulmonary complications in robot-assisted laparoscopic radical prostatectomy”. Journal of Endourology 23 (2009): 1843-1849.
22. López Herranz GP. “Laparoscopic surgery and anesthesia in high-risk patients”. Revista Medica del Hospital Genereal de Mexico. 69.3 (2006): 164-170.
23. Lestar M., et al. “Hemodynamic perturbations during robot-assisted laparoscopic radical prostatectomy in 45 degrees Trendelenburg position”. Anesthesia and Analgesia 113 (2011): 1069-1075.
24. El-Dawlatly A., et al. “Anesthetic considerations with telemanipulative robotic-assisted laparoscopic cholecystectomy using the Da Vinci System”. Internet Journal of Anesthesiology 8 (2004): 2-5.
25. Sprung J., et al. “The impact of morbid obesity, pneumoperitoneum, and posture on respiratory system mechanics and oxygenation during laparoscopy”. Anesthesia and Analgesia 94 (2002): 1345-1350.
26. Danic MJ., et al. “Anesthesia considerations for robotic-assisted laparoscopic prostatectomy: a review of 1,500 cases”. Journal of Robotic Surgery 1 (2007): 119-123.
27. Gainsburg DM. “Anesthetic concerns for roboticassisted laparoscopic radical prostatectomy”. Minerva Anestesiol. 78 (2012): 596-604.
28. Baltayian S. “A brief review: anesthesia for robotic surgery”. Journal of Robotic Surgery 2 (2008): 59-66.