When compared to traditional laparoscopic surgery, the advantages of computer-enhanced surgery are:
The major revolution in robotic surgery was the development of a master-slave surgical platform that returned the wrist to laparoscopic surgery and improved manual dexterity by developing ergonomically comfortable workstation, with 3-D imaging, tremor elimination, and scaling of movements ( eg, large, gross hand movements can be scaled down to allow suturing with microsurgical precision). The most recent it eration of the robotic platform features a second console slave enabling greater assisting and teaching opportunities.
A patient undergoing laparoscopic colon resection is noted to have decreased urine output during the last hour of the case. A bolus is given at the end of the case. One hour later, there is still very poor urine output. The appropriate treatment is:
Low urine output is a normal physiologic response to increased intra-abdominal pressure for up to 1 hour after surgery. Although the effect of the pneumoperitoneum on renal blood flow are immediately reversible, the hormonally mediated changes such as elevated antidiuretic hormone levels decrease urine output for up to 1 hour after the procedure has ended. Intraoperative oliguria is common during laparoscopy, but the urine output is not a reflection of intravascular status; intravenous (IV) fluid administration during an uncomplicated laparoscopic procedure should not be linked to urine output.
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