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For the first stage of the procedure, the patient was placed in the low-lithotomy, steep Trendelenburg position.
Of course, one should always consider that vaginal surgery provides a "minimally invasive" approach without the difficulty of ventilating an obese patient in steep Trendelenburg position.
In 42 patients without cardiopulmonary disease, PPV and SVV were measured before and after administration of 500 ml colloid under pneumoperitoneum combined with the steep Trendelenburg position (35[degrees]).
P]), three minutes after the steep Trendelenburg position (35[degrees] which was measured with protractor) was added to pneumoperitoneum during which time insufflation pressure was set to 15 mmHg ([T.
The main anaesthetic considerations for these Procedures (28,29) are: 1) access to the patient is restricted, because of the large size of the robotic equipment and the spatial restriction after the final positioning and docking of the robot; 2) the patient is in a steep Trendelenburg position for most of the procedure; 3) once the robot is docked, the position of the patient cannot be changed; 4) the surgery is prolonged; and 5) the impact of pneumoperitoneum from carbon dioxide insufflation.
Patients with increased intracranial pressure or increased intraocular pressure (glaucoma) should not undergo robotic surgery in the steep Trendelenburg position.
To prevent sliding in a steep Trendelenburg position, the patient is placed on an egg-crate mattress, and both the patient and the mattress are taped to the table.
During gynaecological laparoscopic surgery the combination of pnuemoperitoneum and the steep Trendelenburg position increases the risk of endobronchial intubation by decreasing the distance between the tip of the endotracheal tube (ETT) and the carina (1,2).
30-180 minutes) with a steep Trendelenburg position.
A minimum degree of Trendelenburg position can be as effective as a steep Trendelenburg position in achieving adequate surgical exposure, thereby allowing safe completion of hysterectomy without increasing operative time.
Difficulty obtaining pneumoperitoneum secondary to preperitoneal fat, difficulty ventilating these women in steep Trendelenburg position, and difficulty gaining adequate exposure during surgery are among the challenges in this patient population, she added.
I typically use an extra-large vacuum bean bag to keep the patient firmly in place while she is in the moderate to steep Trendelenburg position, but the use of a gel pad placed between the patient and the bed is an alternative approach to keep the patient from sliding cephalad during the surgery.