Complications of Robotic Prostatectomy

Abstract

Since its introduction to the United States in 2001, robotic prostatectomy has gained wide acceptance among patients as a preferred treatment for localized prostate cancer. Over five years, the number of centers offering robotic prostatectomy has expanded from 1 to over 300, and the numbers of cases performed annually from 100 to 35,000. While robotic surgery and laparoscopy share most of the general anesthetic complications of open surgery, certain anesthesia-related complications are unique to laparoscopy and robotics. Insufflation of carbon dioxide raises the intra-abdominal pressure which causes an increase in intra-thoracic pressure and vascular resistance, both systemic and pulmonary and therefore increased blood pressure and decreased cardiac output. Urinary retention immediately after catheter removal was the most common cause of deviation from “ideal” course in our series. In our initial experience, we were removing Foley catheters at one to four days postoperatively.