Prostate cancer remains the most common urologic malignancy, and robotic-assisted radical prostatectomy makes the most effective treatment option. The special conditions of the surgery (Trendelenburg position) affect the intraocular pressure.The objective: to systematize new data on changes in intraocular pressure during robotic-assisted radical prostatectomy under various types of general anesthesia. Materials and methods. Publications were reviewed using the PubMed search engine in the electronic databases of Medline, Embase, and Cochrane Library up to August 2020. Results. A total, 9 studies were included in the review including a randomized controlled one. Robot-assisted radical prostatectomy can be a safe surgery regarding perioperative changes in intraocular pressure and ophthalmic complications.Conclusions. The review offers the first assessment of changes in intraocular pressure during robotic-assisted radical prostatectomy. Further studies with a longer follow-up period are needed to determine the clinical efficacy and safety of various types of general anesthesia.

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Introduction. Robot-assisted laparoscopic radical prostatectomy (RALRP) is the most effective treatment option for localized prostate cancer. Special conditions of the surgery (Trendelenburg position and pneumoperitoneum) lead to negative physiological consequences. Objectives. Systematize current data of the effect of total intravenous anesthesia (TIVA) with propofol or inhaled anesthesia with sevoflurane or desflurane on undesirable perioperative events during RALRP in patients with prostate cancer. Materials and methods. Search of PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, International Standard Randomized Register of Controlled Trials, and ClinicalTrials.gov until February 2021. Results. The review included 7 randomized controlled trials. Undesirable perioperative events were nausea and vomiting, decreased jugular venous bulb blood oxygenation, increased optic nerve sheath diameter as a surrogate marker of high intracranial pressure, and high intraocular pressure. Conclusions. We found weak evidence that propofol-based TIVA may have safety advantages over inhaled anesthetics in the anesthesia provision of RARP.

Background. Robot-assisted pelvic surgery rapidly becomes a choice in surgeries for gynaecological oncology and urology. These interventions require special settings (pneumoperitonaeum and Trendelenburg position), which inevitably and systemically impact oxygen transport. Low oxygen delivery during surgery associates with manifold adverse outcomes. A single universal oxygen delivery threshold is impractical, as oxygen consumption must be taken into account. This study examines the effects of pneumoperitonaeum and Trendelenburg position on oxygen transport in patients of ASA functional class I–III (as per American Society of Anaesthesiologists).Materials and methods. Delivery, consumption, oxygen extraction, perioperative adverse events and type of general anaesthesia were prospectively studied in 126 adult patients.Results and discussion. Mean oxygen consumption was 242 mL/min/m2 , mean oxygen delivery — 612 mL/min/m2 . Oxygen delivery was below median 529 mL/min/m2 in 54 (43  %) patients. Perioperative adverse events developed in 36 (29 %) patients. A strong correlation (r > 0.500; p<0.001) between oxygen delivery and consumption was observed in 54 patients. Blood lactate level of 2.7 mmol/L at surgery end was indicative of inadequate oxygen delivery.Conclusion. No relationship was revealed between oxygen delivery and adverse perioperative events, and neither — between oxygen delivery and consumption relative to a particular anaesthetic.