Abstrakt Hrudní chirurgie Říjen 2009

“Robot-assisted thoracoscopic resection of intralobar sequestration.”

Al-Mufarrej, F., M. Margolis, et al. (2009).

Journal of Laparoendoscopic and Advanced Surgical Techniques 19(3): 389-391.


In this paper, we report the first case of a robot-assisted thoracoscopic resection of intralobar sequestration. By virtue of greater dexterity and three-dimensional visualization, the da Vinci robot enables a safer, more precise dissection of sequestered tissue in the face of chronic inflammatory adhesions than conventional video-assisted thoracoscopic surgery does. Thus, in expert hands, such robotic technology is likely to result in less bleeding complications and less conversions to open surgery in cases of sequestration. © 2009 Mary Ann Liebert, Inc.




“An update on robotic thoracic surgery and anesthesia.”

Campos, J. H. (2009).

Curr Opin Anaesthesiol.


PURPOSE OF REVIEW: Minimally invasive surgery involving the thoracic cavity continues to increase. With the introduction of robotic systems, particularly the da Vinci robot system more than 10 years ago, thoracic operations have been performed with some provocative results and limited, defined advantages. The present review provides an overview of common thoracic surgical procedures performed with the robotic system and discusses the anesthetic implications. RECENT FINDINGS: The literature on this topic currently includes case reports or series of clinically prospective or retrospective observational reports with the use of robotic systems, involving the thoracic cavity (mediastinal mass resections, lobectomies, and esophagectomies); unfortunately there are very limited reports related to anesthetic implications or complications related to the use of this technology. The majority of the surgical reports involve the use of lung isolation devices for thoracic surgery, specifically the use of a double-lumen endotracheal tube (DLT); a few centers use carbon dioxide (CO2) insufflation as part of their management to achieve maximal surgical exposure while compressing the operative side of the lung away from the operative area. SUMMARY: Anesthesiologists must be familiar with lung isolation techniques and flexible fiberoptic bronchoscopy while participating in thoracic surgical cases that require robotic systems. In addition, prevention and recognition of potential complications, such as crushing injuries or nerve damage, must be sought. Because the potential for converting to an open thoracotomy exists, all measures must be taken to manage patients accordingly if the situation arises.