Related Experiment Video
Updated: Oct 3, 2025
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Relationship of MRI-measured pelvimetric dimensions and surgical positions with anaesthesia parameters in robotic
Mustafa Gürkan Yenice1, Yavuz Onur Danacıoğlu1, Fatih Akkaş1
1Department of Urology. Bakirkoy Dr. Sadi Konuk and Research Hospital. Istanbul. Turkey.
Introduction And Objective:
Theaim of this study was to determine the effect formedby pelvic diameters preoperatively measured throughmultiparametric magnetic resonance imaging (mp-MRI) and different surgical positions on anesthesiaparameters used during perineal robot-assisted radicalprostatectomy (p-RARP). MATERIALS AND METHODS: Six different pelvimetricdimensions were determined preoperatively.Respiratory and hemodynamic variables of the patientswere measured separately and repeatedly in thesupine position, exaggerated lithotomy position at thebeginning of the 15° Trendelenburg position and the60th minute of insufflation. RESULTS: There was a significant increase in thepartial pressure of oxygen (PaO2) in the exaggeratedlithotomy position compared to the supine position.There was no significant change in the partial pressureof carbon dioxide (PCO2) in the exaggerated lithotomyposition compared to the supine position. In the 60thminute of insufflation, there was a significant increasein the PCO2 compared to the supine and exaggerated lithotomy positions. There was no statistically significantchange in the end-tidal carbon dioxide tension(EtCO2), with surgical position or insufflation time. Asignificant negative correlation was observed betweenthe distance of the ischial spines (ISD) and PCO2 change,and a significant positive correlation was observedbetween the angle of the symphysis pubis-seminalvesicles (ASS) and PCO2 change. A significant positivecorrelation was observed between the ASS value andEtCO2 change between the 60th minute of insufflationand exaggerated lithotomy position. CONCLUSION: In our study, the effect caused by differingpelvimetric diameters, surgical positions, andduration of anesthesia during p-RARP on anesthesiaparameters were shown.
Insights
Pelvic diameters and surgical positions impact anesthesia parameters during robot-assisted radical prostatectomy. Specific pelvic measurements correlate with changes in carbon dioxide levels, guiding anesthetic management for improved patient outcomes.
Area of Science:
- Urology
- Anesthesiology
- Medical Imaging
Background:
- Robot-assisted radical prostatectomy (RARP) is a common procedure for prostate cancer.
- Perineal RARP (p-RARP) requires specific patient positioning.
- Anesthetic parameters can be influenced by surgical positioning and patient anatomy.
Purpose of the Study:
- To assess the impact of preoperative pelvic diameters, measured by multiparametric MRI, on anesthesia parameters.
- To evaluate the effect of different surgical positions on anesthesia parameters during p-RARP.
- To identify correlations between pelvic dimensions and physiological changes during p-RARP.
Main Methods:
- Six pelvic diameters were measured preoperatively using multiparametric MRI.
- Respiratory and hemodynamic variables were recorded in supine and exaggerated lithotomy positions.
- Measurements were taken at the start of 15° Trendelenburg and at 60 minutes of insufflation.
Main Results:
- Oxygen partial pressure (PaO2) increased significantly in the lithotomy position versus supine.
- Carbon dioxide partial pressure (PCO2) increased significantly at 60 minutes of insufflation.
- Pelvic dimensions, such as interspinous distance (ISD) and symphysis pubis-seminal vesicle angle (ASS), correlated with PCO2 and end-tidal CO2 (EtCO2) changes.
Conclusions:
- Pelvic diameters and surgical positioning significantly affect anesthesia parameters during p-RARP.
- Preoperative assessment of pelvic anatomy can inform anesthetic management.
- Understanding these relationships may optimize patient safety and surgical outcomes in p-RARP.
More Related Videos
12:45Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
07:41Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019