• Paola Aceto, Luigi Beretta, Claudia Cariello, Claudia Claroni, Clelia Esposito, Ester M Forastiere, Fabio Guarracino, Raffaella Perucca, Stefano Romagnoli, Liliana Sollazzi, Vito Cela, Alfredo Ercoli, Giovanni Scambia, Enrico Vizza, Giuseppe M Ludovico, Emilio Sacco, Giuseppe Vespasiani, Luigia Scudeller, Antonio Corcione, and Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Società Italiana di Ginecologia e Ostetricia (SIGO), and Società Italiana di Urologia (SIU).
• A. Gemelli University Polyclinic, IRCSS Foundation, Rome, Italy.
• Minerva Anestesiol. 2019 Aug 1; 85 (8): 871-885.

IntroductionProper management of patients undergoing robotic-assisted urologic and gynecologic surgery must consider a series of peculiarities in the procedures for anesthesiology, critical care medicine, respiratory care, and pain management. Although the indications for robotic-assisted urogynecologic surgeries have increased in recent years, specific guidance documents are still lacking.Evidence AcquisitionA multidisciplinary group including anesthesiologists, gynecologists, urologists, and a clinical epidemiologist systematically reviewed the relevant literature and provided a set of recommendations and unmet needs on peculiar aspects of anesthesia in this field.Evidence SynthesisNine core contents were identified, according to their requirements in urogynecologic robotic-assisted surgery: patient position, pneumoperitoneum and ventilation strategies, hemodynamic variations and fluid therapy, neuromuscular block, renal surgery and prevention of acute kidney injury, monitoring the Department of anesthesia, postoperative delirium and cognitive dysfunction, prevention of postoperative nausea and vomiting, and pain management in endometriosis.ConclusionsThis consensus document provides guidance for the management of urologic and gynecologic patients scheduled for robotic-assisted surgery. Moreover, the identified unmet needs highlight the requirement for further prospective randomized studies.

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