Lung Mechanics and Ventilation Efficiency in Robotic Surgery

Robotic surgery requires pneumoperitoneum and specific surgical positioning such as steep Trendelenburg, reverse Trendelenburg, or supine positioning. These intraoperative conditions may lead to cranial displacement of the diaphragm, reduced lung compliance, and increased airway pressures, potentially impairing respiratory mechanics and gas exchange. Previous studies have primarily evaluated respiratory mechanics during robotic surgery at single time points or within specific surgical procedures. However, dynamic changes occurring during critical phases of robotic surgery have rarely been evaluated prospectively. This prospective observational cohort study aims to evaluate phase-specific changes in lung mechanics and ventilation efficiency during robotic surgery. Key parameters including mechanical power (MP), ventilation efficiency index (VEI), static compliance, and driving pressure will be analyzed across predefined intraoperative phases.

Inclusion Criteria * Age ≥ 18 years * Patients undergoing robotic surgery * General anesthesia with mechanical ventilation * Written informed consent Exclusion Criteria * Severe chronic pulmonary disease * Refusal to participate * Missing intraoperative ventilatory data