Anesthesiological Considerations During Robotic Urological Surgery

Abstract

Robotic-assisted surgery has become commonplace in medicine since FDA approval of the da Vinci Surgical System in 2000, and the number cases performed using robotic assistance continues to increase nationwide (Lanfranco et al., Ann Surg 239:14–21, 2004). The benefits of robotic-assisted surgery include decreased blood loss, smaller incision sites, reduced hospital length of stay leading to lower total hospital costs, and possibly better patient outcomes (Lanfranco et al., Ann Surg 239:14–21, 2004). While many fields now use robotic-assisted surgeries, the field of Urology remains at the forefront. Robotic systems, when compared to standard laparoscopy, access deep, small spaces in the pelvis with much better articulation. Common urologic robotic-assisted surgeries include radical and simple prostatectomy, nephrectomy (radical, simple, and partial), and cystoprostatectomy with reconstruction. In 2011, 80% of radical prostatectomies were assisted by robotic surgery systems, and to date, it is the most common procedure to utilize the da Vinci robotic system (Hemal and Menon, Curr Opin Urol 14:89–93, 2004).