title: Concepts in creating an evidence-based anesthetic protocol for robot-assisted laparoscopic pelvic surgery.
abstract: BACKGROUND
  Robotic-assisted surgery has increased in popularity in recent years. Benefits have been observed for both the patient and hospital system as the technology shifts surgery from the open to the laparoscopic arena. Some of the advantages of robotic-assisted surgery include increased patient satisfaction along with shorter hospital stays, decreased risk of infection, and improved postsurgical cosmetic outcomes.
  
  
  METHODS
  We developed an evidence-based protocol for the anesthetic management of the preoperative, intraoperative, and postoperative phases of patient care based on the review of primary literature and consensus from surgeons and anesthesiologists at our institution.
  
  
  RESULTS
  Robotic-assisted surgery creates a unique set of anesthetic considerations to ensure patient safety. Anesthetic considerations include the physiological changes associated with steep Trendelenburg patient positioning, pneumoperitoneum, fluid management, management of pressure points, and spatial restrictions imposed by the robot relative to the conventional anesthetic area.
  
  
  CONCLUSIONS
  A perioperative protocol can help ensure optimal clinical care, patient safety, and better patient and provider satisfaction with the utilization of robotic surgery.
authors.forename: Amit
authors.initials: A
authors.lastname: Prabhakar
authors.forename: Brian L
authors.initials: BL
authors.lastname: Donnenfeld
authors.forename: Alan David
authors.initials: AD
authors.lastname: Kaye
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Feltmate
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000758:Anesthesia / Q000592:standards*; D002985:Clinical Protocols; D019317:Evidence-Based Medicine; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D056888:Patient Positioning; D061214:Patient Safety; D019990:Perioperative Care; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000592:standards*