Difficult Airway and Robotic Surgery: Dual Challenge to Anaesthesiologist

Hemangioma is the most common benign tumour of vascular origin. Risk of rupture and bleeding poses risk to airway. Fibreoptic intubation (FOI) to secure airway can be a valuable option in such a scenario. Steep Trendelenberg’s position with pneumoperitoneum in robotic surgery causes respiratory changes with airway oedema and congestion. Here, we present a case report of a 56-year-old male patient who underwent a robotic radical cystectomy with ileal conduit and urethrectomy due to a massive congenital oral cavity hemangioma and primary urothelial neoplasm of the bladder. We point out the significance of difficult airway management by using fibre optic technique in such cases complicated by steep Trendelenburg’s position required during robotic surgeries.