“Robot-assisted lung resection: outcomes and technical details.”
Giulianotti, P. C., N. C. Buchs, et al. (2010).
Interactive Cardiovascular and Thoracic Surgery.
Robotic surgery has gained acceptance for surgical use but few data exist regarding its value in thoracic procedures. The aim of this study is to report our experience with totally robotic thoracic resections. From June 2001 to June 2009, 38 consecutive totally robotic lung resections were performed in two different hospitals by a single surgeon. All data was prospectively collected in a dedicated database, and reviewed retrospectively. A total of 32 lobectomies, three bilobectomies, and three pneumonectomies were performed. The indication was a malignant tumor in 28 cases. There were nine cases with benign pathology. Mean operating time was 209 min (range: 105-380 min). Six conversions were required (15.8%) and there was one postoperative death (2.6%). Four postoperative complications occurred (10.5%). Median hospital stay was 10 days (range: 3-24 days). After a median follow-up of 42 months, 80% of patients with stage I disease are alive without recurrence. Advanced thoracic procedures can be performed safely using the robotic system. In this heterogeneous series of lung resections, we report low mortality and morbidity. The robotic approach can achieve a good dissection in difficult to reach areas, making it particularly useful for oncologic resections. Keywords: Robot-assisted; Thoracoscopy; Lobectomy; Pneumonectomy; Lung cancer.
“Recent advances in video-assisted thoracoscopic approach to posterior mediastinal tumours.”
Ng, C. S. H., R. H. L. Wong, et al.
Minimal invasive video-assisted thoracic surgery can be a safe alternative technique in the assessment, diagnosis and surgical resection of posterior mediastinal tumours. Video-assisted thoracic surgery may be particularly suited for the management of posterior mediastinal tumours as most are benign. Surgical technique continues to evolve from the classic 3-port access in order to tackle more complex tumours positioned at the apical and inferior recesses of the posterior mediastinum. The preoperative identification of dumbbell tumours is important to facilitate arrangements for a single-stage combined resection for both the intra-thoracic and intraspinal tumour. Results from Video-assisted thoracic surgery posterior mediastinal tumour resection are comparable with conventional surgical techniques in terms of symptomatic improvement, recurrence and survival. Video-assisted thoracic surgery approach has been shown to result in less post-operative pain, improved cosmesis, shorter hospital stay, and more rapid recovery and return to normal activities. In over a decade, video-assisted thoracic surgery has gradually matured and is now a promising therapeutic alternative to open approach. In certain selected patients, video-assisted thoracic surgery may be considered the standard of care for conditions of the posterior mediastinum. Recent developments in robotic surgery for the management of mediastinal tumours are promising, however, long-term results are pending. © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland.
“Robotic-Assisted Resection of a Thymoma After Two Previous Sternotomies.”
Sivarajah, M. and B. Weksler (2010).
Annals of Thoracic Surgery 90(2): 668-670.
Robotic-assisted surgery has emerged as a new strategy for resection of thymomas. It may provide an option for patients who have had prior thoracic procedures, reducing the risks involved with another open procedure. We present a patient with a thymoma occurring after two prior sternotomies for cardiac procedures. A robotic-assisted thymectomy was performed successfully, with no complications. The minimally invasive approach of robotic-assisted resection of thymomas provides a safe alternative to redo sternotomy.