Robotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer
Journal
Journal of Thoracic Disease
Journal Volume
8
Journal Issue
7
Pages
1747-1752
Date Issued
2016
Author(s)
Abstract
Background: The Da Vinci robotic system has been used to enhance the surgeon's visualization and agility in lung cancer surgery, and thus facilitate refined dissection, knot tying and suturing. However, only a few case reports exist on performing a sleeve lobectomy with a robotic-assisted thoracoscopic surgery (RATS) technique. Here we describe our early experience performing RATS sleeve lobectomies. To our knowledge, this is the first study reporting a series of RATS sleeve lobectomies. Methods: The six consecutive NSCLC patients who underwent a RATS sleeve lobectomy between November 2013 and July 2015 at the National Taiwan University Hospital were enrolled in this study. The lobectomies were all performed by the same surgeon using a three-arm robotic system with an additional utility incision made for assistance and specimen retrieval. Results: Five patients were diagnosed with squamous cell carcinoma, while the sixth was diagnosed with a carcinoid tumor. The mean operation time was 436.7 [255-745] minutes. The mean postoperative intensive care unit (ICU) stay and hospital stay were 3.7 [1-11] and 11.3 [3-26] days, respectively. Two (33.3%; 2/6) morbidities were noted, including one pneumonia and one anastomosis stricture. There were no cases of mortality or of conversion to thoracotomy. Conclusions: Our experience performing a RATS sleeve lobectomy in the six patients demonstrated the feasibility of RATS in complex lung cancer surgeries. The three-dimensional vision and articulated joint instruments made robotic-assisted bronchial anastomosis easier under the endoscopic setting. Our experience suggests that RATS offers specific advantages with regard to accuracy and safety when performing sleeve lobectomies. ? Journal of Thoracic Disease.
SDGs
Other Subjects
adult; advanced cancer; aged; anastomosis stenosis; Article; carcinoid; cauterization; clinical article; feasibility study; female; human; intensive care unit; length of stay; lung lobectomy; lymph node dissection; male; middle aged; morbidity; non small cell lung cancer; operation duration; operative blood loss; pneumonia; robot assisted surgery; robotic assisted thoracoscopic sleeve lobectomy; squamous cell lung carcinoma; Taiwan
Publisher
AME Publishing Company
Type
journal article