Anesthesia experience of 192 pediatric urological surgery with da Vinci robotic-assisted laparoscopy
GUO Hang1, WU Tingm1,2, MA Li1, ZHOU Huixia3, AI Xing4, MA Yaqun1
1 Department of Anesthesiology, the Seventh Medical Center to Chinese PLA General Hospital, Beijing 100700, China; 2 Department of Anesthesiology, Shanxi Medical University; 3 Department of Urology, Bayi Children's Hospital Affiliated to the Seventh Medical Center to Chinese PLA General Hospital; 4 Department of Urology, the Seventh Medical Center to Chinese PLA General Hospital
Abstract：Objective： To summarize and discuss the anesthesia experience and the key points of da Vinci robotic-assisted laparoscopy in pediatric urological surgery. Methods： We retrospectively collected and analyze the data of 192 children underwent pediatric urological surgery with da Vinci robotic-assisted laparoscopy in PLA Army general hospital from April 2017 to May 2018 (There were 150 males and 42 girls with age from 8 days after birth to 12 years). Their vital signs and blood gas analysis in different time points were compared with the basal value. Their severe perioperative complications, anesthesia time, operation time, postoperative hospital stay were analyzed. Results： HR、MAP、etCO2 were significantly elevated at 1.5 h after pneumoperitoneum structed compared to that at the baseline before anesthesia induction (P<0.05). PH、PaCO2、K+ were significantly elevated at 1.5 h after pneumoperitoneum structed compared to that at the baseline before pneumoperitoneum (P<0.05). The total of anesthesia time, operation time, postoperative hospital stay was (257.0±39.2) min, (236.4±40.0) min and (12.9±4.0) days respectively. Conclusions： More attention and collaboration is needed during anesthesia and surgery procedure for perioperative security.
[1] REYNOLDS W.The first laparoscopic cholecystectomy. JSLS, 2001,5(1):89-94. [2] SULLIVAN MJ, FROST E, LEW MW.Anesthetic care of the patient for robotic surgery. Middle East J Anaesthesiol, 2008,19(5):967-982. [3] WAGENAAR S, NEDERHOED JH, HOKSBERGEN AW, et al.Minimally invasive, laparoscopic, and robotic-assisted techniques versus open techniques for kidney transplant recipients: a systematic review. Eur Urol, 2017,72(2):205-217. [4] MIRNEZAMI AH, MIRNEZAMI R, VENKATASUBRAMANIAM A, et al.Robotic colorectal surgery: hype or new hope? A systematic review of robotics in colorectal surgery. Colorectal Dis, 2010,12(11):1084-1093. [5] BOWEN DK, VAN BATAVIA JP, SRINIVASAN AK.Single-Site laparoscopy and robotic surgery in pediatric urology. Curr Urol Rep, 2018,19(6):42. [6] SPINOIT AF, NGUYEN H, SUBRAMANIAM R.Role of Robotics in Children: A brave New World! Eur Urol Focus, 2017,3(2-3):172-180. [7] MEIGNAN P, BALLOUHEY Q, LEJEUNE J, et al.Robotic-assisted laparoscopic surgery for pediatric tumors: a bicenter experience. J Robot Surg, 2018,12(3):501-508. [8] FINKELSTEIN JB, LEVY AC, SILVA MV, et al.How to decide which infant can have robotic surgery? Just do the math. J Pediatr Urol, 2015,11(4):e1-e4. [9] AVERY DI, HERBST KW, LENDVAY TS, et al. Robot-assisted laparoscopic pyeloplasty: multiinstitutional experience in infants. J Pediatr Urol, 2015,11(3):139,e1-e5. [10] SROUGI V, YORIOKA M, SANCHEZ DC, et al.The feasibility of robotic urologic surgery in infants and toddlers. J Pediatr Urol, 2013,9(6, B):1198-1203. [11] MUNOZ CJ, NGUYEN HT, HOUCK CS.Robotic surgery and anesthesia for pediatric urologic procedures. Curr Opin Anaesthesiol, 2016,29(3):337-344. [12] BISGAARD T, KLARSKOV B, ROSENBERG J, et al.Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain, 2001,90(3):261-269. [13] ALKHAMESI NA, PECK DH, LOMAX D, et al.Intraperitoneal aerosolization of bupivacaine reduces postoperative pain in laparoscopic surgery:a rando-mized prospective controlled double-blinded clinical trial. Surg Endosc, 2007,21(4):602-606. [14] FREILICH DA, HOUCK CS, MEIER PM, et al.The effectiveness of aerosolized intraperitoneal bupivacaine in reducing postoperative pain in children undergoing robotic-assisted laparoscopic pyeloplasty. J Pediatr Urol, 2008,4(5):337-340.
