Anesthetic considerations for robot-assisted gynecologic and urology surgery

Abstract

Robotic surgery was first conceived by the United States military in the 1980s. It rapidly developed in both complexity and utility and, in the early 21st century, modern robotic surgery for gynecologic and urologic surgery gained approval in the United States. Today, an ever-increasing number and variety of surgical procedures enlist robotic-assistance. Numerous anesthetic considerations for robotic surgery exist. A few of the most important aspects of conducting a safe anesthetic include: investigating the patient's co-morbid conditions, realizing the risks associated with the robotic equipment, and positioning the patient with care. This manuscript reviews the current literature on robotic-assisted surgery for gynecologic and urologic procedures with emphasis on history, marketplace, type, variety, and expansion of surgery in these fields. The review focuses on practical considerations for the anesthesiologist caring for patients undergoing robotic surgery. Preoperative, intraoperative and postoperative issues are explored in detail. The rapid expansion of robotic surgery worldwide requires thoughtful consideration of the technique's weaknesses and associated risks. This review provides a roadmap to adequately prepare anesthesiologists for care of gynecologic and urologic patients undergoing robot-assisted surgery. © 2013 Berger JS, et al.