Lack of funding

This is a pilot study to determine if pulmonary function (lung compliance and ventilation/perfusion matching) is improved using APRV during general anesthesia, compared to the standard CMV. APRV will be tested during anesthesia in 12 patients undergoing robotic-assisted gynecological or genitourinary surgical procedures for definitive cancer treatment, who will also receive CMV.

Inclusion Criteria:

• Participants must have histologically or cytologically confirmed gynecological or genitourinary cancer.
• Subjects will have the physiologic reserve to undergo a robotic-assisted gynecological or genitourinary surgical procedure that uses anesthesia via Airway Pressure Release Ventilation and via Conventional Mechanical Ventilation.
• Adults (≥18 years old)
• ECOG performance status ≤ 2.
• Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

• Vulnerable subjects will not be enrolled for this study.
• Patients who have COPD and are on oxygen at home or who have COPD requiring routine daily inhalers or daytime oxygen are excluded.
• Patients who have history of major lung resection are excluded.
• Patients with body mass index (BMI) >50 are excluded.
• Patients with pulmonary infection within the past 2 months of screening are excluded.
• The availability of oxygen to a fetus during this experimental procedure has not been established. Therefore, patients known to be pregnant per operating room (OR) policy will be excluded.