title: Anesthetic implications of the addition of an operative robot for endoscopic surgery: a case report.
abstract: Laparoscopic surgery has become increasingly popular over the last decade. However, this surgical technique has a number of limitations. It is difficult to work in a three-dimensional space while viewing a two-dimensional monitor, long instruments amplify natural tremor, and traditional instruments have limited mobility due to few degrees of freedom. Robot-assisted surgery has been developed in response to these limitations. A three-dimensional viewer allows the surgeon to operate in a realistic environment, natural tremor is eliminated by translating the surgeon's hand motions to robotic movements, and the robotic surgical instruments are designed to have the same dexterity as a human wrist. We describe a case of robot-assisted laparoscopic Nissen fundoplication and discuss the anesthetic issues associated with this new surgical technique. In addition to the anesthetic issues associated with traditional laparoscopic surgery, robot-assisted laparoscopic surgery presents some unique challenges.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21287-8711, USA. kgagep@yahoo.com
authors.forename: K Gage
authors.initials: KG
authors.lastname: Parr
authors.forename: Mark A
authors.initials: MA
authors.lastname: Talamini
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects*; D004724:Endoscopy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D012371:Robotics / Q000379:methods*