{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:42:21Z","timestamp":1765888941477,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Robotic-assisted surgery is gaining more adaption in different surgical specialties. The number of patients undergoing robotic-assisted thymectomy is continuously increasing. Such procedures are accompanied by new challenges for anesthesiologists. We are presenting our primary anesthesiologic experience in such patients. Methods: This is a retrospective single center study, evaluating 28 patients who presented with thymoma or myasthenia gravis (MG) and undergone minimal invasive robotic-assisted thoracic thymectomy between 01\/2020\u201301\/2022. We present our fast-track anesthesia management as a component of the enhanced recovery program and its primary results. Results: Mean patient\u2019s age was 46.8 \u00b1 18.1 years, and the mean height was 173.1 \u00b1 9.3 cm. Two-thirds of patients were female (n = 18, 64.3%). The preoperative mean forced expiratory volume in the first second (FEV1) was 3.8 \u00b1 0.7 L, forced vital capacity (FVC) was 4.7 \u00b1 1.1 L, and the FEV1\/FVC ratio was 80.4 \u00b1 5.3%. After the creation of capnomediastinum, central venous pressure and airway pressure have been significantly increased from the baseline values (16.5 \u00b1 4.9 mmHg versus 13.4 \u00b1 5.1 mmHg, p &lt; 0.001 and 23.4 \u00b1 4.4 cmH2O versus 19.3 \u00b1 3.9 cmH2O, p &lt; 0.001, respectively). Most patients (n = 21, 75%) developed transient arrhythmias episodes with hypotension. All patients were extubated at the end of surgery and discharged awake to the recovery room. The first 16 (57.1%) patients were admitted to the intensive care unit and the last 12 patients were only observed in intermediate care. Postoperatively, one patient developed atelectasis and was treated with non-invasive ventilation therapy. Pneumonia or reintubation was not observed. Finally, no significant difference was observed between MG and thymoma patients regarding analgesics consumption or incidence of complications. Conclusions: Robotic-assisted surgery is a rapidly growing technology with increased adoption in different specialties. Fast-track anesthesia is an important factor in an enhanced recovery program and the anesthetist should be familiar with challenges in this kind of operation to achieve optimal results. So far, our anesthetic management of patients undergoing robotic-assisted thymectomy reports safe and feasible procedures.<\/jats:p>","DOI":"10.3390\/jcm11154274","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T12:53:45Z","timestamp":1658494425000},"page":"4274","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Anesthetic Management during Robotic-Assisted Minimal Invasive Thymectomy Using the Da Vinci System: A Single Center Experience"],"prefix":"10.3390","volume":"11","author":[{"given":"Ahmed","family":"Mohamed","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1638-0493","authenticated-orcid":false,"given":"Sharaf-Eldin","family":"Shehada","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-991X","authenticated-orcid":false,"given":"Clemens","family":"Aigner","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Medicine Essen\u2014Ruhrlandklinik, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till","family":"Ploenes","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Medicine Essen\u2014Ruhrlandklinik, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yazan","family":"Alnajdawi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Medicine Essen\u2014Ruhrlandklinik, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Van Brakel","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Hochreiter","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6771-3193","authenticated-orcid":false,"given":"Marc Moritz","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Brenner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1439-9035","authenticated-orcid":false,"given":"Ali","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1001\/jama.285.5.568","article-title":"Minimally Invasive and Robotic Surgery","volume":"285","author":"Mack","year":"2001","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.ejcts.2010.08.009","article-title":"Quality of Life after Anterior Mediastinal Mass Resection: A Prospective Study Comparing Open with Robotic-Assisted Thoracoscopic Resection","volume":"39","author":"Balduyck","year":"2011","journal-title":"Eur. 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