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Volumn 78, Issue 5, 2012, Pages 596-604

Anesthetic concerns for robotic-assisted laparoscopic radical prostatectomy

Author keywords

Anesthesia; Perioperative care; Prostatectomy

Indexed keywords

ANESTHESIA; BODY POSITION; BRACHIAL PLEXUS INJURY; CENTRAL VENOUS PRESSURE; CORNEA DISEASE; ENDOTRACHEAL INTUBATION; FACE EDEMA; GAS EMBOLISM; HEART OUTPUT; HEART RATE; HEMODYNAMIC MONITORING; HOMEOSTASIS; HUMAN; INFUSION FLUID; INTRACRANIAL PRESSURE; ISCHEMIC OPTIC NEUROPATHY; LARYNX EDEMA; MEAN ARTERIAL PRESSURE; OXYGEN SATURATION; PATIENT POSITIONING; PERIOPERATIVE PERIOD; PNEUMOPERITONEUM; PRESSURE SUPPORT VENTILATION; PROSTATECTOMY; REVIEW; RISK; ROBOTIC ASSISTED LAPAROSCOPIC RADIAL PROSTATECTOMY; STEEP TRENDELENBURG POSITION; SUBCUTANEOUS EMPHYSEMA; SYSTEMIC VASCULAR RESISTANCE;

EID: 84860281521     PISSN: 03759393     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review
Times cited : (148)

References (55)
  • 1
    • 84860272835 scopus 로고    scopus 로고
    • Intuitive Surgical, Inc., Sunnyvale, Ca, USA. Annual Report
    • Intuitive Surgical, Inc., Sunnyvale, Ca, USA. Annual Report 2010.
    • (2010)
  • 2
    • 84855609553 scopus 로고    scopus 로고
    • Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 (Internet). Lyon, F rance: International Agency for Research in Cancer, [Accessed on December 15, 2011]. Available at
    • Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 (Internet). Lyon, F rance: International Agency for Research in Cancer. [Accessed on December 15, 2011]. Available at: http://globocan.iarc.fr
    • GLOBOCAN 2008 V1.2
    • Ferlay, J.1    Shin, H.R.2    Bray, F.3    Forman, D.4    Mathers, C.5    Parkin, D.M.6
  • 3
    • 46249104633 scopus 로고    scopus 로고
    • A brief review: Anesthesia for robotic surgery
    • Baltayian S. A brief review: anesthesia for robotic surgery. J Robotic Surg 2008;2:59-66.
    • (2008) J Robotic Surg , vol.2 , pp. 59-66
    • Baltayian, S.1
  • 4
    • 4844229216 scopus 로고    scopus 로고
    • Vattikuti Institute prostatectomy: A technique of robotic radical prostatectomy: Experience in more than 1000 cases
    • Menon M, Hemal AK, VIP Team. Vattikuti Institute prostatectomy: a technique of robotic radical prostatectomy: experience in more than 1000 cases. J Endourol 2004;18:611-9.
    • (2004) J Endourol , vol.18 , pp. 611-619
    • Menon, M.1    Hemal, A.K.2    Team, V.I.P.3
  • 5
    • 34548084610 scopus 로고    scopus 로고
    • Robotic radical prostatectomy: Operative technique, outcomes, and learning curve
    • Raman JD, Dong S, Levinson A, Samadi D, Scherr DS. Robotic radical prostatectomy: operative technique, outcomes, and learning curve. JSLS 2007;11:1-7.
    • (2007) JSLS , vol.11 , pp. 1-7
    • Raman, J.D.1    Dong, S.2    Levinson, A.3    Samadi, D.4    Scherr, D.S.5
  • 6
    • 0041633503 scopus 로고    scopus 로고
    • A prospective comparison of radical retropubic and robot-assisted prostatectomy: Experience in one institution
    • Members of the VIP team
    • Tewari A, Srivasatava, Menon M, Members of the VIP team. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int 2003;92:205-10.
    • (2003) BJU Int , vol.92 , pp. 205-210
    • Tewari, A.1    Srivasatava, M.M.2
  • 7
    • 77954544929 scopus 로고    scopus 로고
    • Intraoperative management of robotic-assisted versus open radical prostatectomy
    • Gainsburg DM, Wax D, Reich DL, Carlucci JR, Samadi DB. Intraoperative management of robotic-assisted versus open radical prostatectomy. JSLS 2010;14:1-5.
    • (2010) JSLS , vol.14 , pp. 1-5
    • Gainsburg, D.M.1    Wax, D.2    Reich, D.L.3    Carlucci, J.R.4    Samadi, D.B.5
  • 8
    • 69349104587 scopus 로고    scopus 로고
    • A retrospective comparison of anesthetic management of robotic-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy
    • D'Alonzo RC, Gan TJ, Moul JW, Albala DM, Polascik TJ, Robertson CN et al. A retrospective comparison of anesthetic management of robotic-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy. J Clin Anesth 2009;21:322-8.
    • (2009) J Clin Anesth , vol.21 , pp. 322-328
    • D'alonzo, R.C.1    Gan, T.J.2    Moul, J.W.3    Albala, D.M.4    Polascik, T.J.5    Robertson, C.N.6
  • 9
    • 34247516047 scopus 로고    scopus 로고
    • Anaesthesia for robotic-assisted radical prostatectomy: Considerations for laparoscopy in the Trendelenburg position
    • Phong SVN, Koh LKD. Anaesthesia for robotic-assisted radical prostatectomy: considerations for laparoscopy in the Trendelenburg position. Anaesth Intensive Care 2007;35:281-5.
    • (2007) Anaesth Intensive Care , vol.35 , pp. 281-285
    • Phong, S.V.N.1    Koh, L.K.D.2
  • 10
    • 34347221932 scopus 로고    scopus 로고
    • Anesthesia consideration for robotic-assisted laparoscopic prostatectomy: A review of 1500 cases
    • Danic MJ, Chow M, Gayload A, Bhandari A, Menon M, Brown M. Anesthesia consideration for robotic-assisted laparoscopic prostatectomy: a review of 1500 cases. J Robotic Surg 2007;1:119-23.
    • (2007) J Robotic Surg , vol.1 , pp. 119-123
    • Danic, M.J.1    Chow, M.2    Gayload, A.3    Bhandari, A.4    Menon, M.5    Brown, M.6
  • 11
    • 78649468639 scopus 로고    scopus 로고
    • Incidence of venous gas embolism during robotic-assisted laparoscopic radical prostatectomy is lower than that during radical retropubic prostatectomy
    • Hong JY, Kim JY, Choi YD, Rha KH, Yoon SJ, Kil HK. Incidence of venous gas embolism during robotic-assisted laparoscopic radical prostatectomy is lower than that during radical retropubic prostatectomy. Br J Anaesth 2010;105:777-81.
    • (2010) Br J Anaesth , vol.105 , pp. 777-781
    • Hong, J.Y.1    Kim, J.Y.2    Choi, Y.D.3    Rha, K.H.4    Yoon, S.J.5    Kil, H.K.6
  • 12
    • 77649183818 scopus 로고    scopus 로고
    • 2 Embolism by transesophageal echocardiography during laparoscopic radical prostatectomy
    • 2 Embolism by transesophageal echocardiography during laparoscopic radical prostatectomy. Urology 2010;75:581-4.
    • (2010) Urology , vol.75 , pp. 581-584
    • Hong, J.Y.1    Kim, W.O.2    Kil, H.K.3
  • 15
    • 0033986538 scopus 로고    scopus 로고
    • Effects of neck position and head elevation on intracranial pressure in anesthetized neurological patients
    • Mavrocordatos P, Bissonnette B, Ravussin P. Effects of neck position and head elevation on intracranial pressure in anesthetized neurological patients. J Neurosurg Anesthesiol 2000;12:10-4.
    • (2000) J Neurosurg Anesthesiol , vol.12 , pp. 10-14
    • Mavrocordatos, P.1    Bissonnette, B.2    Ravussin, P.3
  • 17
    • 0031959643 scopus 로고    scopus 로고
    • Mechanism of increased intracranial pressure in rabbits exposed to head down tilt
    • Doi M, Kawai Y. Mechanism of increased intracranial pressure in rabbits exposed to head down tilt. J Physiol 1998;48:63-9.
    • (1998) J Physiol , vol.48 , pp. 63-69
    • Doi, M.1    Kawai, Y.2
  • 18
    • 0343775834 scopus 로고    scopus 로고
    • Changes in cerebral volume with changes in position in awake and anesthetized subjects
    • Lovell AT, Marshall AC, Elwell CE, Smith M, Goldstone JC. Changes in cerebral volume with changes in position in awake and anesthetized subjects. Anesth Analg 2000;90:372-6.
    • (2000) Anesth Analg , vol.90 , pp. 372-376
    • Lovell, A.T.1    Marshall, A.C.2    Elwell, C.E.3    Smith, M.4    Goldstone, J.C.5
  • 19
    • 67651205790 scopus 로고    scopus 로고
    • The effect of pneumoperitoneum in the steep Trendelenburg position on cerebral oxygenation
    • Park EY, Koo BN, Min KT, Nam SH. The effect of pneumoperitoneum in the steep Trendelenburg position on cerebral oxygenation. Acta Anaesthesiol Scand 2009;53:895-9.
    • (2009) Acta Anaesthesiol Scand , vol.53 , pp. 895-899
    • Park, E.Y.1    Koo, B.N.2    Min, K.T.3    Nam, S.H.4
  • 21
    • 33746870428 scopus 로고    scopus 로고
    • New technology for noninvasive brain monitoring: Continuous cerebral oximetry
    • Casati A, Spreafico E, Putzu M, Fanelli G. New technology for noninvasive brain monitoring: continuous cerebral oximetry. Minerva Anesthesiol 2006;72:605-25.
    • (2006) Minerva Anesthesiol , vol.72 , pp. 605-625
    • Casati, A.1    Spreafico, E.2    Putzu, M.3    Fanelli, G.4
  • 22
  • 23
    • 0036308611 scopus 로고    scopus 로고
    • The european association for endoscopic surgery clinical practice guideline on pneumoperitoneum for laparoscopic surgery
    • Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer Hj, Cuschieri A et al. the european association for endoscopic surgery clinical practice guideline on pneumoperitoneum for laparoscopic surgery. surg endosc 2002;16:1121-43.
    • (2002) Surg Endosc , vol.16 , pp. 1121-1143
    • Neudecker, J.1    Sauerland, S.2    Neugebauer, E.3    Bergamaschi, R.4    Hj, B.5    Cuschieri, A.6
  • 24
    • 0030462948 scopus 로고    scopus 로고
    • Cardiopulmonary physiology and pathophysiology as a consequence of laparoscopic surgery
    • Sharma KC, Brandstetter RD, Brensilver JM, Jung LD. Cardiopulmonary physiology and pathophysiology as a consequence of laparoscopic surgery. Chest 1996;110:810-5.
    • (1996) Chest , vol.110 , pp. 810-815
    • Sharma, K.C.1    Brandstetter, R.D.2    Brensilver, J.M.3    Jung, L.D.4
  • 25
    • 80055099153 scopus 로고    scopus 로고
    • Hemodynamic perturbations during robot-assisted laparoscopic radical prostatectomy in 45o Trendelenburg position
    • Lestar M, Gunnarsson L, Lagerstrand L, Wiklund P, Odeberg-Wernerman S. Hemodynamic perturbations during robot-assisted laparoscopic radical prostatectomy in 45o Trendelenburg position. Anesth Analg 2011;113:1069-75.
    • (2011) Anesth Analg , vol.113 , pp. 1069-1075
    • Lestar, M.1    Gunnarsson, L.2    Lagerstrand, L.3    Wiklund, P.4    Odeberg-Wernerman, S.5
  • 27
    • 81955168036 scopus 로고    scopus 로고
    • Haemodynamics and cardiac function during robotic-assisted laparoscopic prostatectomy in steep Trendelenburg position
    • Haas S, Haese A, Goetz AE, Kubitz JC. Haemodynamics and cardiac function during robotic-assisted laparoscopic prostatectomy in steep Trendelenburg position. Int J Med Robotics Comput Assist surg 2011;7:408-13.
    • (2011) Int J Med Robotics Comput Assist Surg , vol.7 , pp. 408-413
    • Haas, S.1    Haese, A.2    Goetz, A.E.3    Kubitz, J.C.4
  • 29
    • 80054943292 scopus 로고    scopus 로고
    • Does intraabdominal pressure affect development of subcutaneous emphysema at gynecologic laparoscopy?
    • Lee DW, Kim MJ, Lee YK, Lee HN. Does intraabdominal pressure affect development of subcutaneous emphysema at gynecologic laparoscopy?. J Min Inv Gyn 2011;18:761-5.
    • (2011) J Min Inv Gyn , vol.18 , pp. 761-765
    • Lee, D.W.1    Kim, M.J.2    Lee, Y.K.3    Lee, H.N.4
  • 30
    • 0034117166 scopus 로고    scopus 로고
    • Risk factors for hypercarbia, subcutaneous emphysema, pneumothorax, and pneumomediastinum during laparoscopy
    • Murdock CM, Wolff AJ, Van Geem T. Risk factors for hypercarbia, subcutaneous emphysema, pneumothorax, and pneumomediastinum during laparoscopy. Obstet Gynecol 2000;95:704-9.
    • (2000) Obstet Gynecol , vol.95 , pp. 704-709
    • Murdock, C.M.1    Wolff, A.J.2    van Geem, T.3
  • 31
    • 0141988857 scopus 로고    scopus 로고
    • Subcutaneous emphysema, pneumomediastinum and bilateral pneumothoraces after laparoscopic pyeloplasty
    • Siu W, Seifman BD, Wolf JS Jr. Subcutaneous emphysema, pneumomediastinum and bilateral pneumothoraces after laparoscopic pyeloplasty. J Urol 2003;170:1936-7.
    • (2003) J Urol , vol.170 , pp. 1936-1937
    • Siu, W.1    Seifman, B.D.2    Wolf Jr., J.S.3
  • 33
    • 79955607824 scopus 로고    scopus 로고
    • Anesthesia for laparoscopic surgery
    • Miller RD, editor, Philadelphia, PA: Churchill Livingstone
    • Joris JL. Anesthesia for laparoscopic surgery. In: Miller RD, editor. Miller's Anesthesia. Philadelphia, PA: Churchill Livingstone; 2010. p. 2185-202.
    • (2010) Miller's Anesthesia , pp. 2185-2202
    • Joris, J.L.1
  • 36
    • 0034945847 scopus 로고    scopus 로고
    • Hemodynamic changes caused by venous air embolism in dogs: Comparisons among air, carbon dioxide and oxygen
    • Liu F C, Tsao CM, Lui PW. Hemodynamic changes caused by venous air embolism in dogs: comparisons among air, carbon dioxide and oxygen. Acta Anaesthesiol Sin 2001;39:71-6.
    • (2001) Acta Anaesthesiol Sin , vol.39 , pp. 71-76
    • Liu, F.C.1    Tsao, C.M.2    Lui, P.W.3
  • 37
    • 42449107836 scopus 로고    scopus 로고
    • Transient paralysis after robotic prostatectomy
    • Deem S, Davis CR, Tierney JP. Transient paralysis after robotic prostatectomy. J Robotic Surg 2008;2:45-6.
    • (2008) J Robotic Surg , vol.2 , pp. 45-46
    • Deem, S.1    Davis, C.R.2    Tierney, J.P.3
  • 38
    • 77956364032 scopus 로고    scopus 로고
    • Pulmonary edema after da Vinci-assisted laparoscopic radical prostatectomy: A case report
    • Hong JY, Oh YJ, Rha KH, Park WS, Kim YS, Kil HK. Pulmonary edema after da Vinci-assisted laparoscopic radical prostatectomy: a case report. J Clin Anesth 2010;22:370-2.
    • (2010) J Clin Anesth , vol.22 , pp. 370-372
    • Hong, J.Y.1    Oh, Y.J.2    Rha, K.H.3    Park, W.S.4    Kim, Y.S.5    Kil, H.K.6
  • 39
    • 84860271341 scopus 로고    scopus 로고
    • Corneal abrasions during laparoscopic prostatectomy: Mechanisms and prevention
    • Banerjee K, Zafirova Z, Tung A. Corneal abrasions during laparoscopic prostatectomy: mechanisms and prevention. Anesthesiology 2008;109:A761.
    • (2008) Anesthesiology , vol.109
    • Banerjee, K.1    Zafirova, Z.2    Tung, A.3
  • 40
    • 33749162187 scopus 로고    scopus 로고
    • The American Society of Anesthesiologists Postoperative Visual Loss Registry: Analysis of 93 spine surgery cases with postoperative visual loss
    • Lee LA, Roth S, Posner KL, Cheney F W, Caplan RA, Newman NJ, Domino KB. The American Society of Anesthesiologists Postoperative Visual Loss Registry: Analysis of 93 spine surgery cases with postoperative visual loss. Anesthesiology 2006;105:652-9.
    • (2006) Anesthesiology , vol.105 , pp. 652-659
    • Lee, L.A.1    Roth, S.2    Posner, K.L.3    Cheney, F.W.4    Caplan, R.A.5    Newman, N.J.6    Domino, K.B.7
  • 41
    • 67849122421 scopus 로고    scopus 로고
    • The effects of steep Trendelenburg positioning on intraocular pressure during robotic radical prostatectomy
    • Awad H, Santilli S, Ohr M, Roth A, Yan W, F ernandez S et al. The effects of steep Trendelenburg positioning on intraocular pressure during robotic radical prostatectomy. Anesth Analg 2009;109:473-8.
    • (2009) Anesth Analg , vol.109 , pp. 473-478
    • Awad, H.1    Santilli, S.2    Ohr, M.3    Roth, A.4    Yan, W.5    F ernandez, S.6
  • 42
    • 84555196762 scopus 로고    scopus 로고
    • Risk factors associated with ischemic optic neuropathy after spinal fusion surgery
    • The Postoperative Visual Loss Study Group
    • The Postoperative Visual Loss Study Group. Risk factors associated with ischemic optic neuropathy after spinal fusion surgery. Anesthesiology 2012;116:15-24.
    • (2012) Anesthesiology , vol.116 , pp. 15-24
  • 43
    • 84860272832 scopus 로고    scopus 로고
    • Anesthetic considerations for robotic urologic surgery
    • Hemal AK, Menon M. editors, London: Springer-Verlag
    • Olympio MA. Anesthetic considerations for robotic urologic surgery. In: Hemal AK, Menon M. editors. Robotics in genitourinary surgery. London: Springer-Verlag; 2011. p. 79-95.
    • (2011) Robotics In Genitourinary Surgery , pp. 79-95
    • Olympio, M.A.1
  • 44
    • 71749085106 scopus 로고    scopus 로고
    • Intraoperative drug-eluting stent thrombosis in a patient undergoing robotic prostatectomy
    • Sharma A, Berkeley A. Intraoperative drug-eluting stent thrombosis in a patient undergoing robotic prostatectomy. J Clin Anesth 2009;21:517-20.
    • (2009) J Clin Anesth , vol.21 , pp. 517-520
    • Sharma, A.1    Berkeley, A.2
  • 45
    • 58749104066 scopus 로고    scopus 로고
    • Practice alert for the perioperative management of patients with coronary artery stents: A report by the American Society Committee on Standards and Practice Parameters
    • American Society of Anesthesiologists Committee on Standards and Practice Parameters
    • American Society of Anesthesiologists Committee on Standards and Practice Parameters. Practice alert for the perioperative management of patients with coronary artery stents: a report by the American Society Committee on Standards and Practice Parameters. Anesthesiology 2009;110:22-3.
    • (2009) Anesthesiology , vol.110 , pp. 22-23
  • 46
    • 0019460805 scopus 로고
    • Anaesthesia for the patient with a coincidental giant lung bulla: A case report
    • Caseby NG. Anaesthesia for the patient with a coincidental giant lung bulla: a case report. Can Anaesth Soc J 1981;28:272-6.
    • (1981) Can Anaesth Soc J , vol.28 , pp. 272-276
    • Caseby, N.G.1
  • 47
    • 84860272830 scopus 로고    scopus 로고
    • Robot-assisted laparoscopic radical prostatectomy in the morbidly obese patient
    • Aricle ID 618623, 5 pages. doi:10.1155/2011/618623
    • Yates J, Munver R, Sawczuk I. Robot-assisted laparoscopic radical prostatectomy in the morbidly obese patient. Prostate Cancer 2011; Aricle ID 618623, 5 pages. doi:10.1155/2011/618623.
    • (2011) Prostate Cancer
    • Yates, J.1    Munver, R.2    Sawczuk, I.3
  • 48
    • 77953768708 scopus 로고    scopus 로고
    • The displacement of the tracheal tube during robot-assisted radical prostatectomy
    • Chang CH, Lee HK, Nam SH. The displacement of the tracheal tube during robot-assisted radical prostatectomy. Eur J Anaesthesiol 2010;27:478-80.
    • (2010) Eur J Anaesthesiol , vol.27 , pp. 478-480
    • Chang, C.H.1    Lee, H.K.2    Nam, S.H.3
  • 49
    • 70449411138 scopus 로고    scopus 로고
    • Effects of thoracic epidural analgesia combined with general anesthesia on intraoperative ventilation/oxygenation and postoperative pulmonary complications in robotassisted laparoscopic radical prostatectomy
    • Hong JY, Lee SJ, Rha KH, Roh GU, Kwon SY, Kil HK. Effects of thoracic epidural analgesia combined with general anesthesia on intraoperative ventilation/oxygenation and postoperative pulmonary complications in robotassisted laparoscopic radical prostatectomy. J Endourol 2009;11:1843-9.
    • (2009) J Endourol , vol.11 , pp. 1843-1849
    • Hong, J.Y.1    Lee, S.J.2    Rha, K.H.3    Roh, G.U.4    Kwon, S.Y.5    Kil, H.K.6
  • 50
    • 11444269860 scopus 로고    scopus 로고
    • Intraoperative positioning nerve injuries
    • Winfree CJ, Kline DG. Intraoperative positioning nerve injuries. Surg Neurol 2005;63:5-18.
    • (2005) Surg Neurol , vol.63 , pp. 5-18
    • Winfree, C.J.1    Kline, D.G.2
  • 51
    • 0027737785 scopus 로고
    • ACCP concensus conference: Mechanical ventilation
    • Slustsky AS. ACCP concensus conference: mechanical ventilation. Chest 1993;104:1833-59.
    • (1993) Chest , vol.104 , pp. 1833-1859
    • Slustsky, A.S.1
  • 52
    • 11844292896 scopus 로고    scopus 로고
    • A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure
    • Guldager H, Nielsen SL, Carl P, Soerensen MB. A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure. Crit Care 1997;1:75-7.
    • (1997) Crit Care , vol.1 , pp. 75-77
    • Guldager, H.1    Nielsen, S.L.2    Carl, P.3    Soerensen, M.B.4
  • 53
    • 84860266484 scopus 로고    scopus 로고
    • Impact of intraoperative fluid management on outcome in patients undergoing robotic-assisted laparoscopic prostatectomy - a retrospective analysis
    • Piegeler T, Dreessen P, Schlapfer M, Schmid DM, Beck-Schimmer B. Impact of intraoperative fluid management on outcome in patients undergoing robotic-assisted laparoscopic prostatectomy - a retrospective analysis. Eur J Anaesth 2011;28: 6AP1-6.
    • (2011) Eur J Anaesth , vol.28
    • Piegeler, T.1    Dreessen, P.2    Schlapfer, M.3    Schmid, D.M.4    Beck-Schimmer, B.5
  • 55
    • 0027934038 scopus 로고
    • Effects of intra-abdominal pressure on renal tissue perfusion during laparoscopy
    • Chiu AW, Azadzoi KM, Hatzichristou DG, et al. Effects of intra-abdominal pressure on renal tissue perfusion during laparoscopy. J Endourol 1994;8:99-103.
    • (1994) J Endourol , vol.8 , pp. 99-103
    • Chiu, A.W.1    Azadzoi, K.M.2    Hatzichristou, D.G.3


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