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Anesthetics in Robotics

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Robotic Urologic Surgery

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Abstract

The widespread adoption of robotic surgery in the field of urology can be attributed to its many advantages, which include improved ergonomics, minimally invasive approach, and decreased length of hospital stay. Anesthetists are therefore required to have an understanding of the unique challenges associated with urological robotic surgery. Additionally, pre-operative screening and optimization allow for the identification and mitigation of patient-specific risk factors.

Common to most robotic surgery patients is the difficulty in managing the combined effects of pneumoperitoneum and the Trendelenburg position, both of which place additional strain on the cardiovascular and respiratory systems. These issues in addition to the most common anesthetic complications associated with robotic surgery are explored and the ways in which they can be prevented are discussed.

Another issue facing anesthetists is the limited access to the patient during robotic surgery. The lack of patient access demands the meticulous placement of monitoring equipment to ensure any deterioration in the patient is rapidly identified. In the event of a surgical or anesthetic emergency, all teams involved in the patient’s intraoperative care should be familiar with emergency undocking protocols. Members of the surgical and anesthetic teams are obliged to review their institutions local protocols to ensure emergency undocking is executed rapidly and safely.

Enhanced recovery after surgery (ERAS) aims to further accelerate the post-operative patient journey through procedure-specific guidelines. These guidelines influence the patient’s pre- and post-operative management and include the following aspects: patient education, choice of analgesia, diet, mobilization targets, and deep venous thrombosis prophylaxis.

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Author information

Authors and Affiliations

  1. Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Ruban Thanigasalam, Joshua Makary & Scott Leslie

  2. The University of Sydney, Sydney, NSW, Australia

    Ruban Thanigasalam, Joshua Makary, Scott Leslie, Ryan Downey, Michael Paleologos & Joanne Irons

  3. Department of Anaesthesia, Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Ryan Downey, Michael Paleologos & Joanne Irons

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  1. Ruban Thanigasalam
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  2. Joshua Makary
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  3. Scott Leslie
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  4. Ryan Downey
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  5. Michael Paleologos
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  6. Joanne Irons
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Editor information

Editors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, USA

    Peter Wiklund

  2. Department of Urology, ORSI Academy, Aalst, Belgium

    Alexandre Mottrie

  3. Pediatric Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

    Mohan S Gundeti

  4. Urology, Global Robotics Institute, Celebration, FL, USA

    Vipul Patel

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Thanigasalam, R., Makary, J., Leslie, S., Downey, R., Paleologos, M., Irons, J. (2022). Anesthetics in Robotics. In: Wiklund, P., Mottrie, A., Gundeti, M.S., Patel, V. (eds) Robotic Urologic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-00363-9_7

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  • DOI: https://doi.org/10.1007/978-3-031-00363-9_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-00362-2

  • Online ISBN: 978-3-031-00363-9

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