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Updated: Jul 31, 2025

Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Anesthetic concerns for robotic-assisted laparoscopic radical prostatectomy: an update
Gabriela Hernandez-Meza1, Daniel M Gainsburg2,3
1Department of Anesthesiology, Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai, The Mount Sinai Medical Center, New York, NY, USA.
Abstract:
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, ocular, 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 updated review will discuss the anesthetic concerns and perioperative management of patients presenting for RALP.
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