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    Anaesthesia For Robotic Surgery: An Experience in Korea

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    anaeshkl
    This document summarizes Dr. Azrin B Mohd Azidin's experience providing anaesthesia for robotic surgery at Severance Hospital in Korea. Some of the key differences they observed include using fentanyl and remifentanil based opioids, limiting EtCO2 levels, and extubating all patients after surgery. The hospital conducts a typical daily elective robotic list and has dedicated robotic operating theaters. Procedures performed include prostatectomies, thyroidectomies using specialized positioning equipment, and gastrectomies. The author submitted a report and plans a manual on robotic procedures to share their learnings.

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    Anaesthesia For Robotic Surgery: An Experience in Korea

    Uploaded by

    anaeshkl
    40 views42 pages
    This document summarizes Dr. Azrin B Mohd Azidin's experience providing anaesthesia for robotic surgery at Severance Hospital in Korea. Some of the key differences they observed include using fentanyl and remifentanil based opioids, limiting EtCO2 levels, and extubating all patients after surgery. The hospital conducts a typical daily elective robotic list and has dedicated robotic operating theaters. Procedures performed include prostatectomies, thyroidectomies using specialized positioning equipment, and gastrectomies. The author submitted a report and plans a manual on robotic procedures to share their learnings.

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    Robotic Seoul2

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    This document summarizes Dr. Azrin B Mohd Azidin's experience providing anaesthesia for robotic surgery at Severance Hospital in Korea. Some of the key differences they observed include using fentanyl and remifentanil based opioids, limiting EtCO2 levels, and extubating all patients after surgery. The hospital conducts a typical daily elective robotic list and has dedicated robotic operating theaters. Procedures performed include prostatectomies, thyroidectomies using specialized positioning equipment, and gastrectomies. The author submitted a report and plans a manual on robotic procedures to share their learnings.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    40 views42 pages

    Anaesthesia For Robotic Surgery: An Experience in Korea

    Uploaded by

    anaeshkl
    This document summarizes Dr. Azrin B Mohd Azidin's experience providing anaesthesia for robotic surgery at Severance Hospital in Korea. Some of the key differences they observed include using fentanyl and remifentanil based opioids, limiting EtCO2 levels, and extubating all patients after surgery. The hospital conducts a typical daily elective robotic list and has dedicated robotic operating theaters. Procedures performed include prostatectomies, thyroidectomies using specialized positioning equipment, and gastrectomies. The author submitted a report and plans a manual on robotic procedures to share their learnings.

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    You are on page 1of 42

    ANAESTHESIA FOR ROBOTIC

    SURGERY
    AN EXPERIENCE IN KOREA
    Dr Azrin B Mohd Azidin
    Anaesthesiologist
    Department of Anaesthesiology and Intensive Care
    Hospital Kuala Lumpur
    The main gate for Severance Hospital, Yonsei
    University Health System in Saedaemun-gu, Seoul
    Click
    Clickicon
    icontotoadd
    addpicture
    picture

    Allen Hall Guest House


    View from the main entrance to Severance Hospital.
    In the bottom right is the entrance to daVinci Robotic
    Training Centre
    Entrance to General OT Complex at
    Severance Hospital
    Click
    Clickicon
    icontotoadd
    addpicture
    picture
    Map of the General OT Complex
    Typical daily elective robotic list for
    Severance Hospital
    Weekly elective robotic schedule
    One of the bigger robotic OT
    (E04)

    robotic OT (E03)
    Recovery Area
    What are the things that they do
    differently…
    Robotic Prostatectomy
    WHAT ARE THE THINGS THAT THEY
    DO DIFFERENTLY…
    • fentanyl and remifentanil based
    opioids
    • glyco-pyrrolate

    • No nasogastric tube

    • OR temperature is > 20 degrees celcius

    • Limit EtCO2 to less than 40 mmHg

    • use Volume control about 5-7 ml/kg

    • No PEEP
    WHAT ARE THE THINGS THAT THEY
    DO DIFFERENTLY…
    • surgical duration is shorter
    • MAC 0.9-1.2
    • do not use ‘bean bag’
    • All are given PCA
    • ALL PATIENTS ARE EXTUBATED
    Intraop Remifentanil and Rocuronium infusion
    PCA fentanyl + ondansetron
    Bolus with basal rate
    (Accufusor)
    PCA fentanyl 1000ug
    + ondansetron 16mg
    in 100 ml solution
    Basal infusion at 0.5
    ml/h
    Bolus dose of 10 ug per
    demand
    Lockout 15 minutes
    Procedures that we plan to do in the
    future….

    A sneek peek….
    Thyroidectomy extension pillow
    Arm rest for ipsilateral arm extension
    Robotic thyroidectomy
    Post anaesthetic induction
    patient positioned with extension pillow
    Ipsilateral arm extended on to the arm rest
    Ipsilateral to the incision site
    Skin retractor for robotic thyroidectomy
    Ongoing case of robotic thyroidectomy
    Restraint for anterior resection
    Restraint for anterior resection
    2 perfusors for remifentanil and rocuronium infusion
    Used in all patients
    Robotic docking for gastrectomy
    Submitted report to MOH
    Planned manual for robotic procedures
    SPECIAL THANKS TO…

    • Dr Ng Siew Hian
    • Ministry of Health Directors and staff
    • Professor Bai Sun Jun ( Yonsei)
    • Mr Nor Ashani ( Consultant Urologist HKL)

    ….. For making this trip possible


    Kamsa-Hamnida….
    (Thank you)

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