Minimally Invasive Robotic Association 2nd International Congress

Taylor, Graham W.

doi:10.1002/rcs.154

Cited by 3 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Robotic assisted surgery (RAS) represents the latest innovation in minimally invasive surgery and its use has became widely spread in all subspecialties of general abdominal surgery including gynecologic procedures, colorectal surgery, gastric surgery and hepatobiliary surgery [1]. …”

Section: Introductionmentioning

confidence: 99%

Obesity is associated with decreased lung compliance and hypercapnia during robotic assisted surgery

Tomescu

Popescu

Dima

et al. 2016

J Clin Monit Comput

View full text Add to dashboard Cite

Robotic assisted surgery (RAS) represents a great challenge for anesthesiology due to the increased intraabdomial pressures required for surgical optimal approach. The changes in lung physiology are difficult to predict and require fast decision making in order to prevent altered gas exchange. The aim of this study was to document the combined effect of patient physical status, medical history and intraoperative position during RAS on lung physiology and to determine perioperative risk factors for hypercapnia. We prospectively analyzed 62 patients who underwent elective RAS. Age, co-morbidities and body mass index (BMI) were recorded before surgery. Ventilatory parameters and arterial blood gas analysis were determined before induction of anesthesia, after tracheal intubation and on an hourly basis until the end of surgery. In RAS, the induction of pneumoperitoneum was associated with a significant decrease in lung compliance from a mean of 42.5–26.7 ml cm H2O−1 (p = 0.001) and an increase in plateau pressure from a mean of 16.1 mmHg to a mean of 23.6 mmHg (p = 0.001). Obesity, demonstrated by a BMI over 30, significantly correlates with a decrease in lung compliance after induction of anesthesia (p = 0.001). A significant higher increase in arterial CO2 tension was registered in patients undergoing RAS in steep Trendelenburg position (p = 0.05), but no significant changes in end-tidal CO2 were recorded. A higher arterial to end-tidal CO2 tension gradient was observed in patients with a BMI > 30 (p < 0.001). In conclusion, patients’ physical status, especially obesity, represents the main risk factor for decreased lung compliance during RAS and patient positioning in either Trendelenburg or steep Trendelenburg during surgery has limited effects on respiratory physiology.

show abstract

Section: Introductionmentioning

confidence: 99%

Obesity is associated with decreased lung compliance and hypercapnia during robotic assisted surgery

Tomescu

Popescu

Dima

et al. 2016

J Clin Monit Comput

View full text Add to dashboard Cite

show abstract

An international, multicentre, prospective, randomised, controlled, unblinded, parallel-group trial of robotic-assisted versus standard laparoscopic surgery for the curative treatment of rectal cancer

Collinson

Jayne

Pigazzi

et al. 2011

Int J Colorectal Dis

243

122

View full text Add to dashboard Cite

In many centres, robotic-assisted surgery is being implemented on the basis of theoretical advantages, which have yet to be confirmed in practice. Robotic surgery is an expensive health care provision and merits robust evaluation. The ROLARR trial is a pragmatic trial aiming to provide a comprehensive evaluation of both robotic-assisted and standard laparoscopic surgery for the curative resection of rectal cancer.

show abstract