title: [Anesthetic management for robot assisted off-pump construction of composite graft using the da Vinci surgical system].
abstract: Robot-assisted minimally invasive surgery has become common in recent years. We used the da Vinci surgical system and managed anesthesia in 6 cases of bilateral internal mammary artery dissection and construction of a composite graft using the radial artery. To ensure vision inside the thoracic cavity, endoscopic robotic surgery employs the inflation of the thoracic cavity with carbon dioxide, producing a pneumothorax and turning the thoracic cavity into a positive pressure chamber. Thus, marked acidosis and circulatory changes manifest during anesthetic management. Although robotic surgery is considered "minimally invasive, such surgery involves a number of problems in terms of anesthetic management, and these problems must be examined.
authors.affiliation: Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Takanashi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Hamano
authors.forename: Kazuto
authors.initials: K
authors.lastname: Miyata
authors.forename: Shouhei
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Atushi
authors.initials: A
authors.lastname: Isshiki
mesh_terms: D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008323:Mammary Arteries / Q000601:surgery*; D008328:Man-Machine Systems; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D017534:Radial Artery / Q000637:transplantation*; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D020858:Tissue and Organ Harvesting / Q000295:instrumentation* / Q000379:methods*