“Appropriate set-up of the da Vinci® Surgical System in relation to the location of anterior and middle mediastinal tumors.”
Kajiwara, N., M. Kakihana, et al. (2011).
Interactive Cardiovascular and Thoracic Surgery 12(2): 112-116.
The da Vinci® Surgical System (dV) and its later version wda Vinci S® Surgical System (dVS)x have been used only in very few cases in selected thoracic surgical areas in Japan. Recently, we used the dV and dVS for various types of anterior and middle mediastinal tumors in clinical practice. We report our experience, and review the settings which depended on tumor location. Six patients gave written informed consent to undergo robotic surgery using the dV or dVS. We evaluated the feasibility, safety and appropriate settings of this system for the surgical treatment of mediastinal tumors. Tumor dissection was performed by two specialists in thoracic surgery certified to use the dV and dVS, and another specialist who acted as an assistant. We were able to access difficult-to-reach areas like the mediastinum. All the resected tumors were classified as benign tumors histologically. Crucial to the success of these operations was the set-up of the dV, which varied according to the location of mediastinal tumors. Robotic surgery enables various types of mediastinal tumor dissection more safely and easily than conventional video-assisted thoracoscopic surgery (VATS). The dV requires the appropriate set-up configuration, which varies according to the location of the mediastinal tumor. © 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
“Comparison of robotic and nonrobotic thoracoscopic thymectomy: A cohort study.”
Ruckert, J. C., M. Swierzy, et al. (2011).
Journal of Thoracic and Cardiovascular Surgery 141(3): 673-677.
OBJECTIVE: Radical thymectomy has become more popular in the comprehensive treatment of myasthenia gravis. Minimally invasive techniques are increasingly used for thymectomy. The most recent development in robotic thoracoscopic surgery has been successfully applied for mediastinal pathologies. To establish robotic technique as a standard, the results of high-volume centers and comparison with traditional surgery are mandatory. METHODS: In a retrospective cohort study, the results of 79 thoracoscopic thymectomies (October 1994 to December 2002) were compared with the results of 74 robotic thoracoscopic thymectomies (January 2003 to August 2006). Data from both series were collected prospectively. In both groups, all patients had myasthenia gravis. Both cohorts were compared with respect to severity of disease, gender, age, histology, and postoperative morbidity. All patients were analyzed for quantification of improvement of disease according to the Myasthenia Gravis Foundation of America. RESULTS: There were no differences in age distribution and severity of myasthenia gravis. The dominant histologic finding was follicular hyperplasia of the thymus in both groups with a significantly higher percentage in the thoracoscopic thymectomy series (68% vs 45%, P < .001). After a follow-up of 42 months, the cumulative complete remission rate of myasthenia gravis for robotic and nonrobotic thymectomy was 39.25% and 20.3% (P = .01), respectively. CONCLUSIONS: There is an improved outcome for myasthenia gravis after robotic thoracoscopic thymectomy compared with thoracoscopic thymectomy.