Anesthesia considerations for robotic surgery in gynecologic oncology

Area of Science:

• Gynecologic Oncology
• Surgical Innovation
• Anesthesiology

Background:

• Robot-assisted surgery in gynecology often requires pneumoperitoneum and prolonged Trendelenburg positioning.
• These conditions can lead to adverse physiological effects for patients.

Purpose of the Study:

• To evaluate the feasibility of robot-assisted gynecologic oncology procedures.
• To identify anesthesia-related peri-operative adverse events in these surgeries.

Main Methods:

• A case series of 133 patients undergoing robot-assisted gynecologic oncology procedures.
• Data collected from electronic health records and a surgical database.
• Review of patient demographics, intra-operative, and post-operative adverse events.

Main Results:

• Robot-assisted surgery was safely performed in diverse patients (age, ASA score, BMI) using extreme Trendelenburg.
• Most patients experienced facial edema; 5% had delayed extubation.
• Transient hypoxemia (3.75%) and hypercapnia (18%) were observed.
• Mean surgery duration was 254 minutes; median hospital stay was 1 day.

Conclusions:

• Robot-assisted gynecologic oncology surgery is safe and feasible, even with prolonged Trendelenburg positioning and pneumoperitoneum.
• Anesthetic and peri-operative complications are rare.
• These procedures offer minimal blood loss and short hospital stays with no significant cardiopulmonary complications.