2018
DOI: 10.4103/ija.ija_96_18
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Anaesthetic management of robotic-assisted gynaecology surgery in the morbidly obese – A case series of 46 patients in a UK university teaching hospital

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Cited by 11 publications
(7 citation statements)
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“…The ability to perform RAL under ultra‐low intra‐abdominal pressure (6 mmHg) has been shown to be feasible without compromising the outcomes and might be advantageous in patients with poor respiratory compliance and obesity 36,37 . Sadashivaiah et al 38 reported on RAL gynaecological surgery in complex patients (BMI over 40 kg/m 2 ), with no conversion to laparotomy and a mean length of stay of 1.57 days. Many women with complex pathology would traditionally have a planned open procedure or a high conversion rate from CL to open, with associated high morbidity 39 .…”
Section: Role Of Robotic Surgery In Complex Gynaecologymentioning
confidence: 99%
“…The ability to perform RAL under ultra‐low intra‐abdominal pressure (6 mmHg) has been shown to be feasible without compromising the outcomes and might be advantageous in patients with poor respiratory compliance and obesity 36,37 . Sadashivaiah et al 38 reported on RAL gynaecological surgery in complex patients (BMI over 40 kg/m 2 ), with no conversion to laparotomy and a mean length of stay of 1.57 days. Many women with complex pathology would traditionally have a planned open procedure or a high conversion rate from CL to open, with associated high morbidity 39 .…”
Section: Role Of Robotic Surgery In Complex Gynaecologymentioning
confidence: 99%
“…GA in steep Trendelenburg with lithotomy position and pneumoperitoneum can lead to reduced functional residual capacity and lung compliance, promote atelectasis, and generate high airway pressures with reduced minute ventilation, hypoxia, and hypercarbia [ 2 , 4 ]. Our mode of ventilation (pressure control) with adequate minute ventilation helped prevent hypercarbia and hypoxia.…”
Section: Discussionmentioning
confidence: 99%
“…We compared the duration of anesthesia, surgery, and console time between the two groups and did not find any statistically significant association. Pneumoperitoneum can reduce GFR and urine output is reduced due to renal ischemia [ 4 ]. However, Parikh et al, in their study on laparoscopic renal transplants, did not find any adverse effects of pneumoperitoneum on renal allograft [ 2 ].…”
Section: Discussionmentioning
confidence: 99%
“…Although few have reported facial puffiness at the end of surgery, Trendelenburg position has been tolerated even in obese patients undergoing robotic gynaecological surgery without any overt evidence of increased intracranial pressure. [ 21 ] Restrictive fluid strategies are shown to be safe and do not affect lactates or renal function in colorectal surgery. [ 22 ] The role of the endothelial glycocalyx in maintaining vascular integrity has been increasingly recognised and conservative fluids help in its preservation.…”
Section: Discussionmentioning
confidence: 99%