In order to improve surgical visibility in robot-assisted laparoscopic radical prostatectomy (RALRP), the steep Trendelenburg position and pneumoperitoneum are used.These procedures can lead to changes in intrathoracic pressure, affecting hemodynamic parameters. There are limited studies on the use of these techniques in robot-assisted surgeries. In this study, we aimed to investigate the effects of the steep Trendelenburg position and pneumoperitoneum on the 'Perfusion Index' (PI) and 'Pleth Variability Index' (PVI) in patients undergoing RYLRP under general anesthesia. After obtaining approval from the Hospital Ethics Committee (E.222840/280) and written consent from patients, 55 patients scheduled for RALRP were included in the study. Patients underwent standard monitoring, and Perfusion Index (PI) and Pleth Variability Index (PVI) were monitored using a finger probe. Measurements were taken before induction, after induction, after adopting the Trendelenburg position, after pneumoperitoneum, after pneumoperitoneum and the Trendelenburg position, at 15 minutes, 30 minutes, in the supine position, after CO2 desufflation, and after extubation. During these stages, PI, PVI, hemodynamic, and respiratory parameters, as well as intraabdominal pressure, were recorded.
