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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2012 May;78(5):596-604
Anesthetic concerns for robotic-assisted laparoscopic radical prostatectomy
Gainsburg D. M. ✉
Departments of Anesthesiology and Urology, The Mount Sinai Medical Center, New York, NY, USA
The anesthetic concerns of patients undergoing robotic-assisted laparoscopic radical prostatectomy (RALP) are primarily related to the use of pneumoperitoneum in the steep Trendelenburg position. This combination will affect cerebrovascular, respiratory and hemodynamic homeostasis. Possible non-surgical complications range from mild subcutaneous emphysema to devastating ischemic optic neuropathy. The anesthetic management of RALP patients involves a thorough preoperative evaluation, careful positioning on the operative table, managing ventilation issues, and appropriate fluid management. Close coordination between the anesthesia and surgical teams is required for a successful surgery. This review will discuss the anesthetic concerns and perioperative management of patients presenting for RALP.