Robotic Surgery for Endometrial Cancer Increases Intraocular Pressure: A Pilot Study [A314]

INTRODUCTION: To evaluate changes in intraocular pressure (IOP) during robotic surgery for endometrial cancer. METHODS: A prospective study in which IOP was measured in the left and right eyes before surgery (PACU), before induction head of bed 30°, after induction 0°, after pneumoperitoneum at 14-mm Hg at 0°, after robot docking at 30° Trendelenburg, after undocking at 30°, and on supine position before extubation. IOP for each patient was averaged between the left and right eyes. Wilcoxon signed-rank tests were performed to evaluate whether IOP changed significantly between baseline (PACU) and the other time points. RESULTS: A total of 15 patients were included. The average IOP before surgery was 15.4±5.45 mm Hg (mean±standard deviation). The intraocular pressure increased significantly after docking the robot (average IOP increase of 9.43 mm Hg; P=.001091), after undocking (average IOP increase of 11.5 mm Hg; P=.0001; Age was 64.27 years old; BMI 38.98 Kg/m2. Tumor grade 1 (60%). Stage IA 67%. Operative time 149.53 minutes. EBL 68.3 mL. There were no intraoperative complications or readmission. CONCLUSION: The intraocular pressure significantly increased during robotic surgery. Caution should be exercised during surgery on patients with glaucoma or increased intracranial pressure as baseline.