First case of combined robot-assisted thymectomy and transaxillary thyroidectomy: technique and robot-docking optimization

Luzzi, Luca; Corzani, Roberto; Burali, Giulia; Ciampelli, L.; Ghisalberti, Marco; Meniconi, Fabiola; Astaneh, A.; Baldi, Marzia; D'Onofrio, Pasquale; Ciabatti, Pier Guido

doi:10.1007/s11701-016-0632-6

Cited by 4 publications

(4 citation statements)

References 2 publications

(1 reference statement)

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“…Compared with open thymectomy, minimally invasive surgical has been associated with lower operative blood loss, shorter hospital stays, shorter length of stay in the intensive care unit, improved postoperative pulmonary function, decreased postoperative pain (1)(2)(3)(4). Robot-assisted thoracoscopic thymectomy (RATT), with da Vinci Surgical Robotic System (Intuitive Surgical, Inc, Sunnyvale, CA, USA), was later introduced, and it became increasingly popular with its benefits over VATT (5)(6)(7)(8). This technology has been performed in many thoracic surgery procedures, with clear evidence that the robotic system provides its best advantage when operating in tiny and difficult-to-reach anatomic regions such as the mediastinum (9,10).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the progression-free survival between robot-assisted thymectomy and video-assisted thymectomy for thymic epithelial tumors: a propensity score matching study

Li¹,

Xu²,

Cong³

et al. 2020

J Thorac Dis

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Background: Robotic system was recently introduced to assist surgeons in performing thymectomy.However, whether robot-assisted thoracoscopic thymectomy (RATT) could replace video-assisted thoracoscopic thymectomy (VATT) and be considered as a superior treatment for thymic epithelial tumors is still controversial. The aim of this study was to evaluate the progression-free survival (PFS) and shortterm clinical outcomes in patients undergoing RATT or VATT by comparing the matched two groups after performing propensity score analysis. Methods: We retrospectively reviewed the clinical data of 295 patients diagnosed with thymic epithelial tumors. There were 60 patients in RATT group and 235 in VATT group. Propensity score matching was done between two groups with variables of age, gender, tumor size, organization histologic classification, original Masaoka stages, presence of myasthenia gravis (MG) and adjuvant therapy. Sixty patients from the RATT group and 60 from the VATT group were matched, fitting the model. The PFS and short-term clinical outcomes of matched groups were compared. Results: After matching, the surgical time in RATT groups was significant shorter than that in VATT groups (P=0.042). Loco-regional recurrence and distal metastasis were detected in 4 patients with thymoma and 1 patient with thymic carcinoma in RATT group and in 25 patients with thymoma and 3 patients with thymic carcinoma in VATT group before matching. PFS were estimated in only thymoma cases. The PFS in RATT group (n=55) intended to be longer than that in VATT group (n=58) after matching (5-year PFS rate: 81.5% and 75.4%, respectively; log-rank P=0.095). Conclusions: RATT has the superiorities over VATT on short-term outcomes due to enabling surgeons to operate in a stable and comfortable environment. Meanwhile, RATT yielded a longer PFS compared with VATT, although the difference was not significant. Therefore, RATT could be considered as a standard approach for the treatment of thymic epithelial tumors.

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Section: Introductionmentioning

confidence: 99%

Comparison of the progression-free survival between robot-assisted thymectomy and video-assisted thymectomy for thymic epithelial tumors: a propensity score matching study

Li¹,

Xu²,

Cong³

et al. 2020

J Thorac Dis

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“…The safe, successful and rapid recovery following a thyroidectomy with concurrent robotic-assisted thymectomy as described by Luzzi et al and in our patient demonstrates a unique treatment strategy for these medically complex patients 12. The new developments in surgical techniques and technologies necessitates a comprehensive review of current standards and guidelines.…”

Section: Discussionmentioning

confidence: 58%

“…We describe here our method of performing a reproducible robotically assisted one-stage thymectomy and thyroidectomy. This minimally invasive alternative more efficiently provides a clinical patient pathway to faster recovery to baseline, and an overall better utilisation of hospital resources with reduced length of stay 12…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive combined approach robotic thymectomy and transcervical total thyroidectomy

et al. 2022

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Myasthenia gravis (MG) is the most common autoimmune disorder affecting the neuromuscular junction in the USA. It is not uncommon for these patients to have concomitant autoimmune diseases including autoimmune thyroid disease. We describe here our method of performing a reproducible robotically assisted one-stage thymectomy and thyroidectomy. An African-American woman presented to our institution with a medical history of hypertension, morbid obesity, type 2 diabetes mellitus, symptomatic MG and symptomatic non-toxic substernal multinodular goitre. A one-stage minimally invasive right-sided robotic radical thymectomy and a transcervical total thyroidectomy with excision of the substernal goitre was successfully performed. The treatment of thyroid and thymus pathologies varies drastically from medical observation to surgery. This combined approach surgery clearly benefits the patient by offering similar operative time, fewer operative and postoperative recovery experiences, decreased anaesthesia risks associated with MG patients through fewer intubations, and a faster return to baseline function.

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“…The fourth arm is located in the 5th intercostal space on anterior axillary line, usually equipped with the tip-up forceps for the lung management. During the last 2 years, we performed two cases of combined cervical and thoracic robotic procedure (16) in patients with synchronous mediastinal lesion and goiter (Figure 10). In case of combined intervention, it is necessary to start with the thoracic resection to maintain the CO 2 -induced pneumothorax.…”

Section: Surgical Techniquementioning

confidence: 99%

Robotic resection of mediastinal goiter and ectopic thyroid

Luzzi¹,

Leonibus²,

Corzani³

et al. 2018

Shanghai Chest

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The last 10 years showed a wild diffusion of mini-invasive thoracic procedures for lung and mediastinum diseases. Mediastinal goiters, ectopic thyroids and forgotten goiters represent rare thoracic diseases, treated in the past by sternotomy, thoracotomy or combined cervicosternotomy. The evolution of robotic assisted thoracic surgery seems to offer a valid therapeutic option also in patients with thoracic and cervicothoracic thyroid correlate diseases. However some contraindications and technical aspects must be taken in account to achieve the best surgical results and patients satisfaction.

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First case of combined robot-assisted thymectomy and transaxillary thyroidectomy: technique and robot-docking optimization

Cited by 4 publications

References 2 publications

Comparison of the progression-free survival between robot-assisted thymectomy and video-assisted thymectomy for thymic epithelial tumors: a propensity score matching study

Comparison of the progression-free survival between robot-assisted thymectomy and video-assisted thymectomy for thymic epithelial tumors: a propensity score matching study

Minimally invasive combined approach robotic thymectomy and transcervical total thyroidectomy

Robotic resection of mediastinal goiter and ectopic thyroid

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