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J Korean Med Assoc > Volume 55(7); 2012 > Article
Sohn and Kim: Anesthetic management for laparoscopic surgery and robotic surgery

Abstract

The advent of minimally invasive surgery has provided many benefits to patients including less trauma, less pain, quicker recovery, and shorter hospital stays. A typical example of a minimally invasive surgery technique is laparoscopic surgery. Intraperitoneal insufflation of carbon dioxide is a routine procedure for creating pneumoperitoneum for accurate visualization and operative manipulation during laparoscopic surgery. However, pneumoperitoneum resulted in ventilatory, respiratory, and hemodynamic changes. Along with these changes, the patient position for the operation complicated anesthetic management. An understanding of these pathophysiologic consequences associated with laparoscopic surgery is important in anesthetic management. Robotic surgery was developed to alleviate the disadvantages of laparoscopic surgery. The advantages of computer-assisted robotic surgery include improved operative field visibility with a three dimensional imaging system and improved control of fine movement. However, the huge size of the robot itself unavoidably invades the anesthetic work space and may impair access to the patient. In addition, repositioning of a patient is almost impossible once the robot has been stationed for surgery. With the innovation of scientific technology, new surgical and anesthetic techniques are being developed for patient care. Anesthesiologists need to be aware of this fast changing surgical field and scientific technology and how it affects anesthetic management.

References

1. Andersson LE, Baath M, Thorne A, Aspelin P, Odeberg-Wernerman S. Effect of carbon dioxide pneumoperitoneum on development of atelectasis during anesthesia, examined by spiral computed tomography. Anesthesiology 2005;102:293-299.

2. Lindsey S. Subcutaneous carbon dioxide emphysema following laparoscopic salpingo-oophorectomy: a case report. AANA J 2008;76:282-285.

3. Ko ML. Pneumopericardium and severe subcutaneous emphysema after laparoscopic surgery. J Minim Invasive Gynecol 2010;17:531-533.

4. Phillips S, Falk GL. Surgical tension pneumothorax during laparoscopic repair of massive hiatus hernia: a different situ-ation requiring different management. Anaesth Intensive Care 2011;39:1120-1123.

5. Ezri T, Khazin V, Szmuk P, Medalion B, Shechter P, Priel I, Loberboim M, Weinbroum AA. Use of the Rapiscope vs chest auscultation for detection of accidental bronchial intubation in non-obese patients undergoing laparoscopic cholecystectomy. J Clin Anesth 2006;18:118-123.

6. Park EY, Kwon JY, Kim KJ. Carbon dioxide embolism during laparoscopic surgery. Yonsei Med J 2012;53:459-466.

7. Koivusalo AM, Lindgren L. Effects of carbon dioxide pneumoperitoneum for laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2000;44:834-841.

8. Rist M, Hemmerling TM, Rauh R, Siebzehnrubl E, Jacobi KE. Influence of pneumoperitoneum and patient positioning on preload and splanchnic blood volume in laparoscopic surgery of the lower abdomen. J Clin Anesth 2001;13:244-249.

9. Kiudelis M, Endzinas Z, Mickevicius A, Pundzius J. Venous stasis and deep vein thrombosis prophylaxis during laparoscopic fundoplication. Zentralbl Chir 2002;127:944-949.

10. Giebler RM, Behrends M, Steffens T, Walz MK, Peitgen K, Peters J. Intraperitoneal and retroperitoneal carbon dioxide insufflation evoke different effects on caval vein pressure gradients in humans: evidence for the starling resistor concept of abdominal venous return. Anesthesiology 2000;92:1568-1580.

11. Moon HS, Lee SK, Choi YS, In CB, Choi EJ. The effect of nitroglycerin on hemodynamic changes during laparoscopic low anterior resection. Korean J Anesthesiol 2011;61:388-393.

12. Laisalmi M, Koivusalo AM, Valta P, Tikkanen I, Lindgren L. Clonidine provides opioid-sparing effect, stable hemodynamics, and renal integrity during laparoscopic cholecystectomy. Surg Endosc 2001;15:1331-1335.

13. Salman N, Uzun S, Coskun F, Salman MA, Salman AE, Aypar U. Dexmedetomidine as a substitute for remifentanil in ambulatory gynecologic laparoscopic surgery. Saudi Med J 2009;30:77-81.

14. White PF, Wang B, Tang J, Wender RH, Naruse R, Sloninsky A. The effect of intraoperative use of esmolol and nicardipine on recovery after ambulatory surgery. Anesth Analg 2003;97:1633-1638.

15. Lentschener C, Axler O, Fernandez H, Megarbane B, Billard V, Fouqueray B, Landault C, Benhamou D. Haemodynamic changes and vasopressin release are not consistently associated with carbon dioxide pneumoperitoneum in humans. Acta Anaesthesiol Scand 2001;45:527-535.

16. Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, Fuchs KH, Jacobi Ch, Jansen FW, Koivusalo AM, Lacy A, McMahon MJ, Millat B, Schwenk W. The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc 2002;16:1121-1143.

17. Concha MR, Mertz VF, Cortinez LI, Gonzalez KA, Butte JM. Pulse contour analysis and transesophageal echocardiography: a comparison of measurements of cardiac output during laparoscopic colon surgery. Anesth Analg 2009;109:114-118.

18. Barnett JC, Hurd WW, Rogers RM Jr, Williams NL, Shapiro SA. Laparoscopic positioning and nerve injuries. J Minim Invasive Gynecol 2007;14:664-672.

19. Sullivan MJ, Frost EA, Lew MW. Anesthetic care of the patient for robotic surgery. Middle East J Anesthesiol 2008;19:967-982.

20. Talamini M, Campbell K, Stanfield C. Robotic gastrointestinal surgery: early experience and system description. J Laparoendosc Adv Surg Tech A 2002;12:225-232.

21. Parr KG, Talamini MA. Anesthetic implications of the addition of an operative robot for endoscopic surgery: a case report. J Clin Anesth 2002;14:228-233.

22. Haas S, Haese A, Goetz AE, Kubitz JC. Haemodynamics and cardiac function during robotic-assisted laparoscopic prostatectomy in steep Trendelenburg position. Int J Med Robot 2011;7:408-413.

23. Ficarra V, Cavalleri S, Novara G, Aragona M, Artibani W. Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol 2007;51:45-55.

24. Mavrocordatos P, Bissonnette B, Ravussin P. Effects of neck position and head elevation on intracranial pressure in anaesthetized neurosurgical patients: preliminary results. J Neurosurg Anesthesiol 2000;12:10-14.

25. Park EY, Koo BN, Min KT, Nam SH. The effect of pneumoperitoneum in the steep Trendelenburg position on cerebral oxygenation. Acta Anaesthesiol Scand 2009;53:895-899.

26. Lestar M, Gunnarsson L, Lagerstrand L, Wiklund P, Odeberg-Wernerman S. Hemodynamic perturbations during robot-assisted laparoscopic radical prostatectomy in 45° Trendelenburg position. Anesth Analg 2011;113:1069-1075.

27. Phong SV, Koh LK. Anaesthesia for robotic-assisted radical prostatectomy: considerations for laparoscopy in the Trendelenburg position. Anaesth Intensive Care 2007;35:281-285.

28. Gainsburg DM. Anesthetic concerns for robotic-assisted laparoscopic radical prostatectomy. Minerva Anestesiol 2012;78:596-604.

29. Field JB, Benoit MF, Dinh TA, Diaz-Arrastia C. Computer-enhanced robotic surgery in gynecologic oncology. Surg Endosc 2007;21:244-246.



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