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Arslan et al. Mini-invasive Surg 2018;2:4 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.31

Review Open Access

Complications of robotic and laparoscopic urologic
surgery relevant to anesthesia

Muhammed Ersagun Arslan , Ayşegül Özgök 2
1
1 Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara 06800, Turkey.
2 Department of Anesthesia and Reanimation, Ankara Yüksekİhtisas Training and Research Hospital, University of Medical Sciences,
Ankara 06230, Turkey.
Correspondence to: Dr. Muhammed Ersagun Arslan, Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara
06800, Turkey. E-mail: dr.ersagun@gmail.com

How to cite this article: Arslan ME, Özgök A. Complications of robotic and laparoscopic urologic surgery relevant to anesthesia. Mini-
invasive Surg 2018;2:4. http://dx.doi.org/10.20517/2574-1225.2017.31

Received: 30 Jul 2017 First Decision: 31 Jan 2018 Revised: 8 Feb 2018 Accepted: 2 Mar 2018 Published: 16 Mar 2018

Science Editor: Yasar Ozgok; Charles F. Bellows Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Technology keeps advancing in this era allowing surgery to become less invasive in many surgical sciences. Besides these
technological advances, minimally invasive procedures such as laparoscopy and robotic assisted laparoscopy are preferred
widely around the globe by both surgeons and patients. Because of the increasing demand to laparoscopy and robotic
surgery, anesthetists also should adapt to these specific surgical procedures. Carbon dioxide (CO 2 ) insufflation is applied
in these procedures in order to provide working space and exposure to target organs. CO 2 insufflation (pneumoperitoneum
if applied intrabdominally) and positional maneuvers such as steep Trendelenburg position is used in urologic laparoscopy
and robotic surgery, which have vital effects on patient’s physiology regarding cardiovascular, respiratory, renal, ocular and
neurological systems. Special positions and unique surgical tools used in these procedures may hinder vital interventions
such as cardiopulmonary resuscitation and open conversion. Comprehension of these pathophysiological effects and
specific considerations is crucial to detect, to prevent and to manage serious complications that may occur during surgery.

Keywords: Anesthesia, complications, laparoscopy, pathophysiological changes robotic surgery, urologic surgery

INTRODUCTION
Minimally invasive surgery is now being applied more and more frequently in urology practice as it is in
other surgical sciences. With the advances in technology, robotics had started to be used in surgery and
robotic surgery followed the widespread use of laparoscopic surgery. Many oncological and reconstructive
surgical operations are performed worldwide with laparoscopic and robotic assisted laparoscopic surgery.

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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