Timing of Recruitment Maneuver in Robotic Prostate Surgery

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.

NCT Number	NCT07662642
Lead Sponsor	Ankara University
Conditions	Robotic Surgery, Urologic Surgical Procedures, Postoperative Pulmonary Complications (PPCs), Pulmonary Atelectasis, Postoperative Complications
Enrollment	86 participants
Start Date	2026-05-09
Primary Completion	2026-07-15 (estimated)
Study Completion	2026-07-20 (estimated)
Updated on ClinicalTrials.gov	2026-06-23