A 63-year-old man underwent a robot-assisted left nephrectomy in the steep Trendelenburg position. The surgery lasted eight hours. The next day, the patient was diagnosed with compartment syndrome of his left leg requiring urgent fasciotomy and debridement. Which of the following factors was MOST likely related to his complication?

Robot-assisted surgeries have been increasingly applied to various surgical procedures in fields such as urology, gynecology, and otolaryngology. The advantages of robot-assisted surgery include reduced blood loss, decreased scarring, and shorter hospital stays. Anesthetic concerns in certain procedures are primarily related to physiological changes resulting from the steep Trendelenburg position and difficulty with ventilation due to pneumoperitoneum.

Compartment syndrome is a clinical condition in which increased pressure within a limited tissue space compromises the circulation, leading to ischemic injury. Compartment syndrome often involves muscles or muscle groups that are enclosed by fascia.

Lower-extremity compartment syndrome has been reported after prolonged procedures...

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