Timing of Recruitment Maneuver in Robotic Prostate Surgery

NCT07662642 | Recruiting

• 1 other identifier: ROBPROREC1
• Study Type: interventional
• Target: 86
• Locations: 1 country
• Sites: 1

Brief Summary

Robotic prostate surgery is commonly performed under general anesthesia with carbon dioxide pneumoperitoneum and steep Trendelenburg positioning. These conditions may reduce lung volumes, impair respiratory mechanics, and increase the risk of atelectasis and postoperative pulmonary complications. Recruitment maneuvers combined with individualized positive end-expiratory pressure may improve intraoperative oxygenation and lung compliance; however, the optimal timing of recruitment maneuver application in robotic prostate surgery remains unclear. This prospective randomized study aims to compare the effects of recruitment maneuver timing on postoperative pulmonary complications in adult patients undergoing elective robotic prostate surgery. Participants will be randomized into two groups. In the Supine Recruitment Group, the recruitment maneuver will be performed before carbon dioxide insufflation while the patient is in the supine position, followed by individualized PEEP determination. In the Trendelenburg Recruitment Group, the recruitment maneuver will be performed after pneumoperitoneum and Trendelenburg positioning, followed by individualized PEEP determination. Patients will be evaluated for postoperative pulmonary complications up to postoperative 72 hours or until discharge, whichever occurs first.

Conditions

Robotic Surgery; Urologic Surgical Procedures; Postoperative Pulmonary Complications (PPCs); Pulmonary Atelectasis; Postoperative Complications

Keywords

Robotic prostate surgery; Recruitment maneuver; Pneumoperitoneum; Trendelenburg position; Positive end-expiratory pressure; Atelectasis; Postoperative pulmonary complications; General anesthesia

Outcome Measures

Primary Outcomes (1)

• Incidence of postoperative pulmonary complications

  Postoperative pulmonary complications will be evaluated after surgery, including clinically relevant pulmonary events such as atelectasis, hypoxemia, respiratory infection, bronchospasm, aspiration pneumonitis, respiratory failure, need for noninvasive or invasive ventilatory support, or other predefined pulmonary complications according to the study protocol.

  From the end of surgery to postoperative 72 hours or until hospital discharge, whichever occurs first.

Secondary Outcomes (1)

• Length of hospital stay

  From the day of surgery to hospital discharge, assessed up to 30 days.

Other Outcomes (1)

• Intraoperative respiratory system compliance and oxygenation

  Intraoperative period

Study Arms (2)

Supine Recruitment Group

EXPERIMENTAL

After routine ASA monitoring and induction of general anesthesia, patients will receive a recruitment maneuver before carbon dioxide insufflation while in the supine position. Individualized PEEP will then be determined using decremental PEEP titration.

Procedure: Recruitment maneuver in the supine position

Trendelenburg Recruitment Group

ACTIVE COMPARATOR

After routine ASA monitoring and induction of general anesthesia, carbon dioxide insufflation and Trendelenburg positioning will be performed. The recruitment maneuver will then be applied, followed by individualized PEEP determination using decremental PEEP titration.

Procedure: Recruitment maneuver after insufflation and Trendelenburg positioning

Interventions

Recruitment maneuver after insufflation and Trendelenburg positioning PROCEDURE

A lung recruitment maneuver will be applied after pneumoperitoneum and Trendelenburg positioning, followed by individualized PEEP determination using decremental PEEP titration.

Trendelenburg Recruitment Group

Recruitment maneuver in the supine position PROCEDURE

The recruitment maneuver will be performed while the patient is in the supine position, before pneumoperitoneum insufflation and Trendelenburg positioning during robotic prostate surgery. The maneuver will be applied according to the predefined intraoperative ventilation protocol to improve alveolar recruitment and reduce postoperative pulmonary complications.

Supine Recruitment Group

Eligibility Criteria

• Age: 18 Years+
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients scheduled for elective robotic prostate surgery
• Age 18 years or older
• Body mass index between 18 and 35 kg/m²
• No cognitive impairment
• Ability to provide written informed consent

You may not qualify if:

• Age younger than 18 years
• Emergency surgery
• Preoperative oxygen requirement
• Cognitive impairment
• Refusal to participate in the study

Sponsors & Collaborators

• Ankara University: lead

Study Sites (1)

Ankara University Faculty of Medicine

Ankara, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• Canet J, Mazo V. Postoperative pulmonary complications. Minerva Anestesiol. 2010 Feb;76(2):138-43. Epub 2009 Nov 24.

  PMID: 20150855 BACKGROUND

• Sumer I, Topuz U, Alver S, Umutoglu T, Bakan M, Zengin SU, Coskun H, Salihoglu Z. Effect of the "Recruitment" Maneuver on Respiratory Mechanics in Laparoscopic Sleeve Gastrectomy Surgery. Obes Surg. 2020 Jul;30(7):2684-2692. doi: 10.1007/s11695-020-04551-y.

  PMID: 32207048 BACKGROUND

• Futier E, Constantin JM, Pelosi P, Chanques G, Kwiatkoskwi F, Jaber S, Bazin JE. Intraoperative recruitment maneuver reverses detrimental pneumoperitoneum-induced respiratory effects in healthy weight and obese patients undergoing laparoscopy. Anesthesiology. 2010 Dec;113(6):1310-9. doi: 10.1097/ALN.0b013e3181fc640a.

  PMID: 21068660 BACKGROUND

Related Links

• Online ARISCAT score calculator used for preoperative estimation of postoperative pulmonary complication risk in surgical patients.

MeSH Terms

Conditions

Pulmonary Atelectasis; Postoperative Complications; Pneumoperitoneum

Interventions

Head-Down Tilt

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Peritoneal Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

Posture; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Participants and outcome assessors were masked to group allocation. The anesthesiologist performing the recruitment maneuver was not masked because of the nature of the intervention.
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: June 11, 2026
• First Posted: June 23, 2026
• Study Start: May 9, 2026
• Primary Completion: July 15, 2026
• Study Completion: July 20, 2026
• Last Updated: June 23, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)