Yıl: 2024 Cilt: 52 Sayı: 2 Sayfa Aralığı: 39 - 48 Metin Dili: İngilizce DOI: 10.4274/TJAR.2023.231315 İndeks Tarihi: 11-06-2024

Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients

Öz:
Obesity is associated with many significant physiological changes. These considerations are important to surgery, especially in urological procedures. Obese patients often undergo surgical procedures and are at higher risk of complications. This investigation reviews physiological and anaesthesia considerations for obese and morbidly obese patients. In addition, urological surgeries and procedures should be considered for these higher risk patients. Clinical anaesthesiologists must use detailed assessment and, when appropriate, consultation in developing safe anaesthesia plans for these patients. Newer technologies have improved safety related to airway management, advanced airway devices, and regional anaesthesia with ultrasound-guided nerve blocks, which can reduce the need for opioids postoperatively. Recent developments in drug and monitoring technologies have also been developed and can be effective for obese and morbidly obese patients undergoing urological procedures and perioperative surgery, thus improving the likelihood of safety in this higher risk population.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
0
0
0
  • 1. CDC. Obesity is a Common, Serious, and Costly Disease. Centers for Disease Control and Prevention. Published July 20, 2022. Accessed October 9, 2023. [CrossRef]
  • 2. Calle EE, Teras LR, Thun MJ. Obesity and mortality. N Engl J Med. 2005;353(20):2197-2199. [CrossRef]
  • 3. Wiltz AL, Shikanov S, Eggener SE, et al. Robotic radical prostatectomy in overweight and obese patients: oncological and validated-functional outcomes. Urology. 2009;73(2):316-322. [CrossRef]
  • 4. Yates J, Munver R, Sawczuk I. Robot-assisted laparoscopic radical prostatectomy in the morbidly obese patient. Prostate Cancer. 2011;2011:618623. [CrossRef]
  • 5. Cestari A, Sangalli M, Buffi NM, et al. Robotic assisted radical prostatectomy in morbidly obese patients: how to create a cost-effective adequate optical trocar. J Robot Surg. 2013;7:47-51. [CrossRef]
  • 6. Kott O, Golijanin B, Pereira JF, et al. The BMI Paradox and Robotic Assisted Partial Nephrectomy. Front Surg. 2020;6:74. [CrossRef]
  • 7. Tomescu DR, Popescu M, Dima SO, Bacalbașa N, Bubenek- Turconi Ș. Obesity is associated with decreased lung compliance and hypercapnia during robotic assisted surgery. J Clin Monit Comput. 2017;31(1):85-92. [CrossRef]
  • 8. Menderes G, Gysler SM, Vadivelu N, Silasi DA. Challenges of Robotic Gynecologic Surgery in Morbidly Obese Patients and How to Optimize Success. Curr Pain Headache Rep. 2019;23(7):51. [CrossRef]
  • 9. Dalton A. Obesity and Robotic Surgery. Anesth Patient Saf Found Newsl. 2018;33(2)33-68. [CrossRef]
  • 10. Rouby JJ, Monsel A, Lucidarme O, Constantin JM. Trendelenburg Position and Morbid Obesity: A Respiratory Challenge for the Anesthesiologist. Anesthesiology. 2019;131(1):10-13. [CrossRef]
  • 11. Valenza F, Vagginelli F, Tiby A, et al. Effects of the beach chair position, positive end-expiratory pressure, and pneumoperitoneum on respiratory function in morbidly obese patients during anesthesia and paralysis. Anesthesiology. 2007;107(5):725-732. [CrossRef]
  • 12. Lee JR. Anesthetic considerations for robotic surgery. Korean J Anesthesiol. 2014;66(1):3-11. [CrossRef]
  • 13. Nguyen NT, Wolfe BM. The physiologic effects of pneumoperitoneum in the morbidly obese. Ann Surg. 2005;241(2):219-226. [CrossRef]
  • 14. Darlong V, Kunhabdulla NP, Pandey R, et al. Hemodynamic changes during robotic radical prostatectomy. Saudi J Anaesth . 2012;6(3):213- 218. [CrossRef]
  • 15. Ghomi A, Kramer C, Askari R, Chavan NR, Einarsson JI. Trendelenburg position in gynecologic robotic-assisted surgery. J Minim Invasive Gynecol. 2012;19(4):485-489. [CrossRef]
  • 16. Lindner U, Lawrentschuk N, Abouassaly R, Fleshner NE, Trachtenberg J. Radical prostatectomy in obese patients: Improved surgical outcomes in recent years. Int J Urol. 2010;17(8):727-732. [CrossRef]
  • 17. Imber DA, Pirrone M, Zhang C, Fisher DF, Kacmarek RM, Berra L. Respiratory Management of Perioperative Obese Patients. Respir Care. 2016;61(12):1681-1692. [CrossRef]
  • 18. Grieco DL, Anzellotti GM, Russo A, et al. Airway Closure during Surgical Pneumoperitoneum in Obese Patients. Anesthesiology. 2019;131(1):58-73. [CrossRef]
  • 19. Cozowicz C, Memtsoudis SG. Perioperative Management of the Patient With Obstructive Sleep Apnea: A Narrative Review. Anesth Analg. 2021;132(5):1231-1243. [CrossRef]
  • 20. Kilic OF, Börgers A, Köhne W, Musch M, Kröpfl D, Groeben H. Effects of steep Trendelenburg position for robotic-assisted prostatectomies on intra- and extrathoracic airways in patients with or without chronic obstructive pulmonary disease. Br J Anaesth. 2015;114(1):70-76. [CrossRef]
  • 21. Bennicoff G. Perioperative care of the morbidly obese patient in the lithotomy position. AORN J . 2010;92(3):297-309; quiz 310-312. [CrossRef]
  • 22. Menezes S, Rodrigues R, Tranquada R, Müller S, Gama K, Manso T. Injuries resulting from positioning for surgery: incidence and risk factors. Acta Med Port. 2013;26(1):12-16. [CrossRef]
  • 23. Cassorla LLJ, Miller RD. Miller’s Anesthesia. 8th ed. Elsevier; 2015. [CrossRef]
  • 24. Wicklin SAV. Challenges in the operating room with obese and extremely obese surgical patients. Int J SPHM. 2018;8:120-131. [CrossRef]
  • 25. Knipper S, Mazzone E, Mistretta FA, et al. Impact of Obesity on Perioperative Outcomes at Robotic-assisted and Open Radical Prostatectomy: Results From the National Inpatient Sample. Urology. 2019;133:135-144. [CrossRef]
  • 26. Han H, Cao Z, Qin Y, et al. Morbid obesity is adversely associated with perioperative outcomes in patients undergoing robot- assisted laparoscopic radical prostatectomy. Can Urol Assoc J. 2020;14(11):E574-E581. [CrossRef]
  • 27. Nik Ahd F, Howard LE, Aronson WJ, et al. Obese men undergoing radical prostatectomy: Is robotic or retropubic better to limit positive surgical margins? Results from SEARCH. Int J Urol. 2020;27(10):851- 857. [CrossRef]
  • 28. Wei Y, Wu YP, Lin MY, et al. Impact of Obesity on Long-Term Urinary Incontinence after Radical Prostatectomy: A Meta-Analysis. Biomed Res Int. 2018;2018:8279523. [CrossRef]
  • 29. Yu J, Park JY, Kim DH, et al. Incidence and Risk Factors of Pulmonary Complications after Robot-Assisted Laparoscopic Prostatectomy: A Retrospective Observational Analysis of 2208 Patients at a Large Single Center. J Clin Med. 2019;8(10):1509. [CrossRef]
  • 30. Porcaro AB, Sebben M, Tafuri A, et al. Body mass index is an independent predictor of Clavien-Dindo grade 3 complications in patients undergoing robot assisted radical prostatectomy with extensive pelvic lymph node dissection. J Robot Surg. 2019;13(1):83- 89. [CrossRef]
  • 31. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-213. [CrossRef]
  • 32. Pathak RA, Wilson RRA, Craven TE, Matz E, Hemal AK. The role of body mass index on quality indicators following minimally- invasive radical prostatectomy. Investig Clin Urol. 2021;62(3):290-297. [CrossRef]
  • 33. Cassorla, L L J. Patient positioning and associated risks. In: Miller RD, Eriksson LI, Fleisher LA, et al. Miller’s Anesthesia. 8th ed. Elsevier/ Saunders; 2015:1240-1265. [CrossRef]
  • 34. Lew MW, Sullivan MJ. Anesthesia for Laparoscopic and Robotic- Assisted Urological Procedures. In: Anesthesia for Urologic Surgery. 2013:93-126. [CrossRef]
  • 35. Pedoto A. Lung physiology and obesity: anesthetic implications for thoracic procedures. Anesthesiol Res Pract. 2012;2012:154208. [CrossRef]
  • 36. Lamvu G, Zolnoun D, Boggess J, Steege JF. Obesity: physiologic changes and challenges during laparoscopy. Am J Obstet Gynecol. 2004;191(2):669-674. [CrossRef]
  • 37. Yurashevich M, Habib AS. Anesthetic management for robotic hysterectomy in obese women. Curr Opin Anaesthesiol. 2021;34(3):238- 245. [CrossRef]
  • 38. Scheib SA, Tanner E 3rd, Green IC, Fader AN. Laparoscopy in the morbidly obese: physiologic considerations and surgical techniques to optimize success. J Minim Invasive Gynecol . 2014;21(2):182-195. [CrossRef]
  • 39. Wilson RL, Shannon T, Calton E, et al. Efficacy of a weight loss program prior to robot assisted radical prostatectomy in overweight and obese men with prostate cancer. Surg Oncol. 2020;35:182-188. [CrossRef]
  • 40. Blecha S, Harth M, Zeman F, et al. The impact of obesity on pulmonary deterioration in patients undergoing robotic-assisted laparoscopic prostatectomy. J Clin Monit Comput. 2019;33(1):133-143. [CrossRef]
  • 41. Gad M, Gaballa K, Abdallah A, Abdelkhalek M, Zayed A, Nabil H. Pressure-Controlled Ventilation with Volume Guarantee Compared to Volume-Controlled Ventilation with Equal Ratio in Obese Patients Undergoing Laparoscopic Hysterectomy. Anesth Essays Res. 2019;13(2):347-353. [CrossRef]
  • 42. Jun IJ, Kim M, Lee J, et al. Effect of Mannitol on Ultrasonographically Measured Optic Nerve Sheath Diameter as a Surrogate for Intracranial Pressure During Robot-Assisted Laparoscopic Prostatectomy with Pneumoperitoneum and the Trendelenburg Position. J Endourol. 2018;32(7):608-613. [CrossRef]
APA Khater N, MORRİS A, D, garcia A, Jin K, Ahmadzadeh S, shekoohi S, Cornett E, Kaye A (2024). Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. , 39 - 48. 10.4274/TJAR.2023.231315
Chicago Khater Nazih,MORRİS Anna G., Delena,garcia Andrew,Jin Kevin,Ahmadzadeh Shahab,shekoohi Sahar,Cornett Elyse M,Kaye Alan Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. (2024): 39 - 48. 10.4274/TJAR.2023.231315
MLA Khater Nazih,MORRİS Anna G., Delena,garcia Andrew,Jin Kevin,Ahmadzadeh Shahab,shekoohi Sahar,Cornett Elyse M,Kaye Alan Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. , 2024, ss.39 - 48. 10.4274/TJAR.2023.231315
AMA Khater N,MORRİS A, D,garcia A,Jin K,Ahmadzadeh S,shekoohi S,Cornett E,Kaye A Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. . 2024; 39 - 48. 10.4274/TJAR.2023.231315
Vancouver Khater N,MORRİS A, D,garcia A,Jin K,Ahmadzadeh S,shekoohi S,Cornett E,Kaye A Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. . 2024; 39 - 48. 10.4274/TJAR.2023.231315
IEEE Khater N,MORRİS A, D,garcia A,Jin K,Ahmadzadeh S,shekoohi S,Cornett E,Kaye A "Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients." , ss.39 - 48, 2024. 10.4274/TJAR.2023.231315
ISNAD Khater, Nazih vd. "Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients". (2024), 39-48. https://doi.org/10.4274/TJAR.2023.231315
APA Khater N, MORRİS A, D, garcia A, Jin K, Ahmadzadeh S, shekoohi S, Cornett E, Kaye A (2024). Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. Turkish Journal of Anaesthesiology and Reanimation, 52(2), 39 - 48. 10.4274/TJAR.2023.231315
Chicago Khater Nazih,MORRİS Anna G., Delena,garcia Andrew,Jin Kevin,Ahmadzadeh Shahab,shekoohi Sahar,Cornett Elyse M,Kaye Alan Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. Turkish Journal of Anaesthesiology and Reanimation 52, no.2 (2024): 39 - 48. 10.4274/TJAR.2023.231315
MLA Khater Nazih,MORRİS Anna G., Delena,garcia Andrew,Jin Kevin,Ahmadzadeh Shahab,shekoohi Sahar,Cornett Elyse M,Kaye Alan Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. Turkish Journal of Anaesthesiology and Reanimation, vol.52, no.2, 2024, ss.39 - 48. 10.4274/TJAR.2023.231315
AMA Khater N,MORRİS A, D,garcia A,Jin K,Ahmadzadeh S,shekoohi S,Cornett E,Kaye A Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. Turkish Journal of Anaesthesiology and Reanimation. 2024; 52(2): 39 - 48. 10.4274/TJAR.2023.231315
Vancouver Khater N,MORRİS A, D,garcia A,Jin K,Ahmadzadeh S,shekoohi S,Cornett E,Kaye A Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients. Turkish Journal of Anaesthesiology and Reanimation. 2024; 52(2): 39 - 48. 10.4274/TJAR.2023.231315
IEEE Khater N,MORRİS A, D,garcia A,Jin K,Ahmadzadeh S,shekoohi S,Cornett E,Kaye A "Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients." Turkish Journal of Anaesthesiology and Reanimation, 52, ss.39 - 48, 2024. 10.4274/TJAR.2023.231315
ISNAD Khater, Nazih vd. "Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients". Turkish Journal of Anaesthesiology and Reanimation 52/2 (2024), 39-48. https://doi.org/10.4274/TJAR.2023.231315