Minerva Anestesiologica 2018 October;84(10):1189-1208

Antonio CORCIONE ¹, Pierluigi ANGELINI ², Lapo BENCINI ³, Elisabetta BERTELLINI ⁴, Felice BORGHI ⁵, Claudio BUCCELLI ⁶, Giuseppe COLETTA ⁷, Clelia ESPOSITO ¹, Vincenzo GRAZIANO ⁸, Fabio GUARRACINO ⁸, Domenico MARCHI ⁹, Pasquale MISITANO ¹⁰, Anna M. MORI ¹¹, Mariano PATERNOSTER ⁶, Vincenzo PENNESTRÌ ¹², Vittorio PERRONE ¹³, Luigi PUGLIESE ¹⁴, Stefano ROMAGNOLI ¹⁵, Luigia SCUDELLER ¹⁶ ✉, Francesco CORCIONE ² on behalf of Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) and Società Italiana di Chirurgia (SIC)

¹ Department of Critical Care Area, A.O. Ospedali dei Colli, Monaldi Hospital, Naples, Italy; ² Department of General, Laparoscopic and Robotic Surgery, A.O. Ospedali dei Colli, Monaldi Hospital, Naples, Italy; ³ Division of Surgical Oncology and Robotics, Department of Oncology, Careggi University Hospital, Florence, Italy; ⁴ Department of Anesthesia and Intensive Care, New Civile S. Agostino-Estense, Policlinico Hospital, Modena, Italy; ⁵ Division of General and Surgical Oncology, Department of Surgery, S. Croce e Carle Hospital, Cuneo, Italy; ⁶ Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy; ⁷ Division of Operating Room Management, Department of Emergency and Critical Care, S. Croce e Carle Hospital, Cuneo, Italy; ⁸ Department of Anesthesia and Critical Care Medicine, Cardiothoracic Anesthesia and Intensive Care, Pisa University Hospital, Pisa, Italy; ⁹ Department of General Surgery, New Civile S. Agostino-Estense, Policlinico Hospital, Modena, Italy; ¹⁰ Unit of General and Mini-Invasive Surgery, Department of General Surgery, Misericordia Hospital, Grosseto, Italy; ¹¹ Department of Anesthesiology and Reanimation, IRCCS Policlinic San Matteo Foundation, Pavia, Italy; ¹² Department of Anesthesia and Intensive Care Medicine, Misericordia Hospital, Grosseto, Italy; ¹³ Department of General and Transplant Surgery, Pisa University Hospital, Pisa, Italy; ¹⁴ Unit of General Surgery 2, IRCCS Policlinic San Matteo, Foundation, Pavia, Italy; ¹⁵ Department of Anesthesia and Critical Care, Careggi University Hospital, Florence, Italy; ¹⁶ Unit of Clinical Epidemiology, Scientific Direction, IRCCS Policlinic San Matteo Foundation, Pavia, Italy

Minimally invasive surgical procedures have revolutionized the world of surgery in the past decades. While laparoscopy, the first minimally invasive surgical technique to be developed, is widely used and has been addressed by several guidelines and recommendations, the implementation of robotic-assisted surgery is still hindered by the lack of consensus documents that support healthcare professionals in the management of this novel surgical procedure. Here we summarize the available evidence and provide expert opinion aimed at improving the implementation and resolution of issues derived from robotic abdominal surgery procedures. A joint task force of Italian surgeons, anesthesiologists and clinical epidemiologists reviewed the available evidence on robotic abdominal surgery. Recommendations were graded according to the strength of evidence. Statements and recommendations are provided for general issues regarding robotic abdominal surgery, operating theatre organization, preoperative patient assessment and preparation, intraoperative management, and postoperative procedures and discharge. The consensus document provides evidence-based recommendations and expert statements aimed at improving the implementation and management of robotic abdominal surgery.

KEY WORDS: Robotic surgical procedures - Anesthesiology - Consensus - Evidence-based practice