Robotic-Assisted Prostatectomy

Anesthesia Implications

Position: Lithotomy, Trendelenburg, arms tucked
Time: 2-4 hours (long)
Blood Loss: Low (10-50 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: Yes

Urinary output can be tricky to assess. We keep these patients as dry as possible to avoid urine spillage into the peritoneal cavity.

Face protection is a must. Most facilities will be requiring goggles. Some providers will use the foam donut over the face. Robotic arms and lines will be operating very close to the patient’s face. You’ll want to make sure lines, equipment, or providers are not resting on or colliding with the face.

If regional is used, T8-T10 level is optimal.

Tucked Arms (general considerations): Consider a second IV – once the procedure has started, it’s going to be VERY difficult to handle IV issues – especially if your only IV has problems. Ensure the IV is running and monitors are still functioning after tucking the patient’s arms

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Long procedure (general considerations): Procedures anticipated to last longer than 2 hours generally require a urinary catheter. Also consider checking lines and positioning regularly as the risks of infiltration and nerve damage are increased with procedure time. Consider an IV fluid warmer and a forced air warmer to keep the patient euthermic.