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Anesthesia for Robotic Thoracic Surgery

  • Javier Campos
Chapter

Abstract

The management of the robotic thoracic surgical patient requires the knowledge of minimally invasive surgery techniques involving the chest. Familiarity with the da Vinci® robot surgical system by the anesthesiologist is mandatory. Management of one-lung ventilation techniques with a left-sided double-lumen endotracheal tube or an independent bronchial blocker is required, along with flexible fiberoptic bronchoscopy techniques. Patient positioning and prevention of complications such as nerve or crashing injuries while the robotic system is used. Recognition of the hemodynamic effects of carbon dioxide (CO2) during insufflation in the chest is required. Potential for conversion to open thoracotomy or open procedure in the abdomen.

Keywords

Robotic Surgery Open Thoracotomy Robotic Surgical System Lung Isolation Operating Room Table 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Tatooles AJ, Pappas PS, Gordon PJ, Slaughter MS. Minimally invasive mitral valve repair using the da Vinci robotic system. Ann Thorac Surg. 2004;77:1978–82.PubMedCrossRefGoogle Scholar
  2. 2.
    Nifong LW, Chitwood WR, Pappas PS, Smith CR, Argenziano M, Starnes VA, et al. Robotic mitral valve surgery: a United States multicenter trial. J Thorac Cardiovasc Surg. 2005;129:1395–404.PubMedCrossRefGoogle Scholar
  3. 3.
    Rea F, Marulli G, Bortolotti L, Feltracco P, Zuin A, Sartori F. Experience with the “da Vinci” robotic system for thymectomy in patients with myasthenia gravis. Ann Thorac Surg. 2006;8:455–9.CrossRefGoogle Scholar
  4. 4.
    Savitt MA, Gao G, Furnary AP, Swanson J, Gately HL, Handy JR. Application of robotic-assisted techniques to the surgical evaluation and treatment of the anterior mediastinum. Ann Thorac Surg. 2005;79:450–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Kernstine KH, DeArmond DT, Shamoun DM, Campos JH. The first series of completely robotic esophagectomies with three-field lymphadenectomy: initial experience. Surg Endosc. 2007;21:2285–92.PubMedCrossRefGoogle Scholar
  6. 6.
    Mack MJ. Minimally invasive and robotic surgery. JAMA. 2001;285:568–72.PubMedCrossRefGoogle Scholar
  7. 7.
    Campos JH. An update on robotic thoracic surgery and ­anesthesia. Curr Opin Anaesthesiol. 2010;23:1–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Bodner J, Wykypiel H, Wetscher G, Schmid T. First experiences with the da Vinci operating robot in thoracic surgery. Eur J Cardiothorac Surg. 2004;25:844–51.PubMedCrossRefGoogle Scholar
  9. 9.
    Rückert JC, Ismail M, Swierzy M, Sobel H, Rogalla P, Meisel A, et al. Thoracoscopic thymectomy with the da Vinci robotic system for myasthenia gravis. Ann NY Acad Sci. 2008;1132:329–35.PubMedCrossRefGoogle Scholar
  10. 10.
    Baraka A. Onset of neuromuscular block in myasthenic patients. Br J Anaesth. 1992;69:227–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Abel M, Eisenkraft JB. Anesthetic implications of myasthenia gravis. Mt Sinai J Med. 2002;69:31–7.PubMedGoogle Scholar
  12. 12.
    Pandey R, Elakkumanan LB, Garg R, Jyoti B, Mukund C, Chandralekha, et al. Brachial plexus injury after robotic-assisted thoracoscopic thymectomy. J Cardiothorac Vasc Anesth 2009;23:584–6.Google Scholar
  13. 13.
    Bodner J, Wykypiel H, Greiner A, Kirchmayr W, Freund MC, Margreiter R, et al. Early experience with robot-assisted surgery for mediastinal masses. Ann Thorac Surg. 2004;78:259–65.PubMedCrossRefGoogle Scholar
  14. 14.
    Park BJ, Flores RM, Rusch VW. Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results. J Thorac Cardiovasc Surg. 2006;131:54–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Anderson CA, Filsoufi F, Aklog L, Farivar RS, Byrne JG, Adams DH. Robotic-assisted lung resection for malignant disease. Innovations. 2007;2:254–8.Google Scholar
  16. 16.
    Gharagozloo F, Margolis M, Tempesta B, Strother E, Najam F. Robot-assisted lobectomy for early-stage lung cancer: report of 100 consecutive cases. Ann Thorac Surg. 2009;88:380–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Campos JH. Update on tracheobronchial anatomy and flexible fiberoptic bronchoscopy in thoracic anesthesia. Curr Opin Anaesthesiol. 2009;22:4–10.PubMedCrossRefGoogle Scholar
  18. 18.
    Campos JH. Progress in lung separation. Thorac Surg Clin. 2005;15:71–83.PubMedCrossRefGoogle Scholar
  19. 19.
    Nifong LW, Chitwood Jr WR. Challenges for the anesthesiologist: robotics? Anesth Analg. 2003;96:1–2.PubMedGoogle Scholar
  20. 20.
    Wolfer RS, Krasna MJ, Hasnain JU, McLaughlin JS. Hemodynamic effects of carbon dioxide insufflation during thoracoscopy. Ann Thorac Surg. 1994;58:404–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Ohtsuka T, Nakajima J, Kotsuka Y, Takamoto S. Hemodynamic response to intrapleural insufflation with hemipulmonary collapse. Surg Endosc. 2001;15:1327–30.PubMedCrossRefGoogle Scholar
  22. 22.
    El-Dawlatly AA, Al-Dohayan A, Samarkandi A, Algahdam F, Atef A. Right vs left side thoracoscopic sympathectomy: effects of carbon dioxide insufflation on haemodynamics. Ann Chir Gynaecol. 2001;90:206–8.PubMedGoogle Scholar
  23. 23.
    El-Dawlatly AA, Al-Dohayan A, Abdel-Meguid ME, Turkistani A, Alotaiby WM, Abdelaziz EM. Variations in dynamic lung compliance during endoscopic thoracic sympathectomy with carbon dioxide insufflation. Clin Auton Res. 2003;13 Suppl 1:I94–7.PubMedGoogle Scholar
  24. 24.
    Kernstine KH, DeArmond DT, Karimi M, Van Natta TL, et al. The robotic, 2-stage, 3-field esophagolymphadenectomy. J Thorac Cardiovasc Surg. 2004;127:1847–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Bodner JC, Zitt M, Ott H, Wetscher GJ, et al. Robotic-assisted thoracoscopic surgery (RATS) for benign and malignant esophageal tumors. Ann Thorac Surg. 2005;80:1202–6.PubMedCrossRefGoogle Scholar
  26. 26.
    van Hillegersberg R, Boone J, Draaisma WA, Broeders IA, et al. First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer. Surg Endosc. 2006;20:1435–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Kim DJ, Hyung WJ, Lee CY, Lee JG, Haam SJ, Park IK, et al. Thoracoscopic esophagectomy for esophageal cancer: feasibility and safety of robotic assistance in the prone position. J Thorac Cardiovasc Surg. 2010;139:53–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Gutt CN, Bintintan VV, Köninger J, Müller-Stich BP, Reiter M, Büchler MW. Robotic-assisted transhiatal esophagectomy. Langenbecks Arch Surg. 2006;391:428–34.PubMedCrossRefGoogle Scholar
  29. 29.
    Watson TJ. Robotic esophagectomy: is it an advance and what is the future? Ann Thorac Surg. 2008;85:757–9.CrossRefGoogle Scholar
  30. 30.
    Czibik G, D’Ancona G, Donias HW, Karamanoukian HL. Robotic cardiac surgery: present and future applications. J Cardiothorac Vasc Anesth. 2002;16:495–501.PubMedCrossRefGoogle Scholar
  31. 31.
    Hubens G, Ruppert M, Balliu L, Vaneerdeweg W. What have we learnt after two years working with the da Vinci robot system in digestive surgery? Acta Chir Belg. 2004;104:609–14.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Javier Campos
    • 1
  1. 1.Department of AnesthesiaUniversity of Iowa Health Care, Roy and Lucille Carver College of MedicineIowa CityUSA

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