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Anesthetic Considerations for Robotic Urologic Surgery

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Robotics in Genitourinary Surgery

Abstract

This chapter will focus upon the complex physiology and implications of pneumoperitoneum (PPT) and the Trendelenburg position (TP) which challenges the anesthetic management through the neurologic, pulmonary, cardiovascular, hepatic, and renal systems. Robotic-assisted laparoscopic urologic surgery (RALUS) limits access to the limbs and hinders routine monitoring and its interpretation, primarily from hydrostatic gradients. Although the effects of capnoperitoneum (CPT) for laparoscopic cholecystectomy (Lap-C) have been well described, the added effects of TP have not. The predominant types of RALUS (prostatectomy, cystectomy, and nephrectomy) differ in anesthetic management secondary to position, complexity, organ function, duration, access, morbidity, length of stay, and postoperative recovery. The anesthesia team should know their surgeon’s outcomes regarding these factors in order to best manage the anesthetic.

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  1. Departments of Anesthesiology and Urology, Baptist Medical Center, Wake Forest University Health Sciences, Winston-Salem, NC, 27157–1009, USA

    Michael A. Olympio

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Correspondence to Michael A. Olympio .

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  1. Medical Sciences, Dept. Urology, All India Institute of, Ansari Nagar, New Dehli, 110029, India

    Ashok Kumar Hemal

  2. Henry Ford Health System, W. Grand Blvd. 2799, Detroit, 48202, Michigan, USA

    Mani Menon

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Olympio, M.A. (2011). Anesthetic Considerations for Robotic Urologic Surgery. In: Hemal, A., Menon, M. (eds) Robotics in Genitourinary Surgery. Springer, London. https://doi.org/10.1007/978-1-84882-114-9_6

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