Abstract
BackgroundThe number of robot-assisted surgeries being performed has increased in recent years, even in patients with risk factors, such as obesity, owing to advancements in medical technologies. We here report the anesthetic management of a morbidly obese woman who underwent robot-assisted surgery.Case presentationA 44-year-old woman (height, 165 cm; weight, 147 kg; body mass index, 54 kg/m2) was scheduled to undergo robot-assisted laparoscopic hysterectomy for endometrial cancer. Preoperative weight loss and rehearsal of positioning during induction of anesthesia and surgical procedures greatly contributed to the surgical success. Monitoring of oxygen reserve index in combination with SpO2 was useful for appropriate airway and respiratory management. During anesthesia induction, the ramp position using a special commercially available cushion facilitated manual mask ventilation and tracheal intubation. Lung-protective ventilation using a limited tidal volume with moderate PEEP was applied during the robot-assisted surgical procedure.ConclusionWe successfully managed anesthesia without any complications.
Highlights
The number of robot-assisted surgeries being performed has increased in recent years, even in patients with risk factors, such as obesity, owing to advancements in medical technologies
Case presentation A 44-year-old woman who was diagnosed with endometrial cancer was scheduled for a robot-assisted hysterectomy under general anesthesia
Mechanical ventilation was performed by pressure control ventilation (FiO2, 0.45; inspiratory pressure, 30 cmH2O; Positive end-expiratory pressure (PEEP), 10 cmH2O; and inspiratory to expiratory time ratio, 1:2), and the respiratory rate was adjusted to maintain end-tidal Carbon dioxide (CO2) at between 40 and 50 mmHg
Summary
The number of robot-assisted surgeries being performed has increased in recent years, even in patients with risk factors, such as obesity, owing to advancements in medical technologies. We here report the anesthetic management of a morbidly obese patient with a body mass index (BMI) of more than 50 kg/m2, who underwent robot-assisted hysterectomy.
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