SynthesisJournal of robotic surgery2022
Influence of steep Trendelenburg position on postoperative complications: a systematic review and meta-analysis.
Synthesis in Journal of robotic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 31 citations in OpenAlex.
- Trial
- Perioperative management and challenges of robotic-assisted surgery: a narrative review.Journal of robotic surgery · 2026Review
- Comparison Study of Inverted-Nipple Ureteroneocystostomy and Direct Anastomosis in U-Shaped Orthotopic Neobladder Reconstruction.Annals of surgical oncology · 2026Article
- [Anesthesia for robot-assisted surgery].Die Anaesthesiologie · 2026Review
- Patient positioning in robot-assisted pelvic urologic surgery: bibliometric mapping of physiologic changes, positioning-related complications, and preventive strategies.Journal of robotic surgery · 2026Article
- Cerebral hemodynamics, autoregulation, and neurocognitive outcomes during Trendelenburg positioning in robot-assisted abdominopelvic surgery: a narrative review.Journal of robotic surgery · 2026Review
- da Vinci robotic-assisted surgery: implications for modern anesthetic practice.Journal of robotic surgery · 2026Review
- Anesthesia for robot-assisted surgery: a review.Anaesthesiology intensive therapy · 2025Review
- Navigating challenges in anesthesia for robotic urological surgery: a comprehensive guide.Journal of robotic surgery · 2024Review
- The duration of spinal anaesthesia in elective caesarean section in Trendelenburg and reverse Trendelenburg positions: a randomized clinical trial.Annals of medicine and surgery (2012) · 2024Article
- Upper extremity contact pressure measurement in robot-assisted pelvic surgery.Journal of robotic surgery · 2024Article
- Effect of the Duration of Restrictive Fluid Therapy on Acute Kidney Injury in Robot-Assisted Laparoscopic Prostatectomy.Journal of personalized medicine · 2023Article
- Robot-Assisted versus Laparoscopic Gastrointestinal Surgery: A Systematic Review and Metanalysis of Intra- and Post-Operative Complications.Journal of personalized medicine · 2023Article
- Lung mechanics during video-assisted abdominal surgery in Trendelenburg position: a cross-sectional propensity-matched comparison between classic laparoscopy and robotic-assisted surgery.BMC anesthesiology · 2022Article
- The Impact of Steep Trendelenburg Position on Intraocular Pressure.Journal of clinical medicine · 2022Review
- Impact of Intraperitoneal Drain Placement on Postoperative Pain After Total Laparoscopic Hysterectomy.JSLS : Journal of the Society of Laparoendoscopic SurgeonsObservational
Corrections and comments
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Authors and funding
16 authors at 11 institutions in 12 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Intraoperative physiologic changes related to the steep Trendelenburg position have been investigated with the widespread adoption of robot-assisted pelvic surgery (RAPS). However, the impact of the steep Trendelenburg position on postoperative complications remains unclear. We conducted a meta-analysis to compare RAPS to laparoscopic/open pelvic surgery with regards to the rates of venous thromboembolism (VTE), cardiac, and cerebrovascular complications. Meta-regression was performed to evaluate the influence of confounding risk factors. Ten randomized controlled trials (RCTs) and 47 non-randomized controlled studies (NRSs), with a total of 380,125 patients, were included. Although RAPS was associated with a decreased risk of VTE and cardiac complications compared to laparoscopic/open pelvic surgery in NRSs [risk ratio (RR), 0.59; 95% CI 0.51-0.72, p < 0.001 and RR 0.93; 95% CI 0.58-1.50, p = 0.78, respectively], these differences were not confirmed in RCTs (RR 0.92; 95% CI 0.52-1.62, p = 0.77 and RR 0.93; 95% CI 0.58-1.50, p = 0.78, respectively). In subgroup analyses of laparoscopic surgery, there was no significant difference in the risk of VTE and cardiac complications in both RCTs and NRSs. In the meta-regression, none of the risk factors were found to be associated with heterogeneity. Furthermore, no significant difference was observed in cerebrovascular complications between RAPS and laparoscopic/open pelvic surgery. Our meta-analysis suggests that the steep Trendelenburg position does not seem to affect postoperative complications and, therefore, can be considered safe with regard to the risk of VTE, cardiac, and cerebrovascular complications. However, proper individualized preventive measures should still be implemented during all surgeries including RAPS to warrant patient safety.
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