Hottenrott Sebastian, Schlesinger Tobias, Helmer Philipp, Meybohm Patrick, Alkatout Ibrahim, Kranke Peter
Department of Anesthesiology and Critical Care, University Hospital Wuerzburg, 97080 Wuerzburg, Germany.
Department of Gynaecology and Obstetrics, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, 24105 Kiel, Germany.
J Clin Med. 2020 Dec 15;9(12):4058. doi: 10.3390/jcm9124058.
Laparoscopic techniques have established themselves as a major part of modern surgery. Their implementation in every surgical discipline has played a vital part in the reduction of perioperative morbidity and mortality. Precise robotic surgery, as an evolution of this, is shaping the present and future operating theatre that an anesthetist is facing. While incisions get smaller and the impact on the organism seems to dwindle, challenges for anesthetists do not lessen and could even become more demanding than in open procedures. This review focuses on the pathophysiological effects of contemporary laparoscopic and robotic procedures and summarizes anesthetic challenges and strategies for perioperative management.
腹腔镜技术已成为现代外科手术的重要组成部分。其在各个外科领域的应用对降低围手术期发病率和死亡率起到了至关重要的作用。作为腹腔镜技术的进一步发展,精准机器人手术正在塑造麻醉医生当前及未来所面对的手术室环境。虽然手术切口变小,对机体的影响似乎也在减小,但麻醉医生面临的挑战并未减少,甚至可能比开放手术要求更高。本文综述聚焦于当代腹腔镜和机器人手术的病理生理效应,并总结围手术期管理的麻醉挑战及策略。