Initial Experiences With Robotic Single-Site Thoracic Surgery for Mediastinal Masses

Park, Sung Yong; Kim, Hyun Koo; Jang, Dong Su; Han, Kook Nam; Kim, Dae Joon

doi:10.1016/j.athoracsur.2018.08.016

Cited by 15 publications

(11 citation statements)

References 11 publications

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“…Early robotic surgery introduced the use of multiple arms; however, robotic single-site approaches using the da Vinci Si system Original Article Initial experience with and surgical outcomes of da Vinci single-port system in general thoracic surgery (Intuitive Surgical Inc., Sunnyvale, CA, USA) have also been attempted through enlarged 3-4-cm single incisions. We previously reported our experience with robotic singlesite thoracic surgery in the excision of mediastinal masses (1,2). Even though the number of incisions and ports can be reduced using the single-site platform of the da Vinci system, the approach has limitations, such as nonarticulating instruments with a lack of free wrist movements and long distance (8 cm) between the incision and the target lesion.…”

Section: Introductionmentioning

confidence: 99%

Initial experience with and surgical outcomes of da Vinci single-port system in general thoracic surgery

Park¹,

Lee²,

Stein³

et al. 2022

J Thorac Dis

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Background:The da Vinci single-port system (SPS) (Model SP1098, Intuitive Surgical Inc., Sunnyvale, CA, USA) has been used in genitourinary and general surgical procedures; however, its clinical application in general thoracic surgery has not been attempted. This retrospective study investigated the clinical outcomes of SPS in general thoracic surgery.Methods: After approval from the Ministry of Food and Drug Safety in Korea, the surgical details of SPS in simple thoracic surgeries at two independent institutions were collected and retrospectively reviewed.Results: Overall, 17 surgeries were performed using SPS without conversion to multiport surgery. The patients included six males, and the overall median age was 52 years (range, 28-83 years). The commonest pathological diagnoses were thymoma (8 cases) and benign cystic lesions (6 cases). The approach for SPS was subxiphoid, subcostal, and intercostal in 11, 4, and 2 cases, respectively. All patients underwent the surgeries without complications. The median operation time and peak pain score were 120 minutes (range, 58-250 minutes) and 3 (range, 2-4). The median duration of in situ chest tube and hospital stay was 1 day (range, 1-2 days) and 3 days (range, 2-7 days), respectively. SPS showed a shorter duration of in situ chest tube and hospital stay than robotic single-site surgeries. Conclusions:The application of SPS in the field of general thoracic surgery is feasible and can be successful. Although this study reported preliminary data and the cases were relatively simple, advanced and complex procedures should be attempted with the SPS in the near future.

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Section: Introductionmentioning

confidence: 99%

Initial experience with and surgical outcomes of da Vinci single-port system in general thoracic surgery

Park¹,

Lee²,

Stein³

et al. 2022

J Thorac Dis

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“…Visualization and dexterity of the robotic instruments in this narrow compartment, where the thymic tissue sites are better provided in the subxiphoid approach. Another limitation of the single-site platform described in our previous article (10) is the inevitable adaptation of VATS during dissection of the lower one-third of the mediastinum. Owing to the innate performance restriction of the system, the site within 8 cm from the port cannot be reached with the robotic instruments.…”

Section: Discussionmentioning

confidence: 99%

Biportal robotic surgery for anterior mediastinal mass

Hong¹,

Lee²,

Kim³

2023

Ann Cardiothorac Surg

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Background: Robotic-assisted surgery for mediastinal disease has been shown to be beneficial in facilitating easier mediastinal dissection with its three-dimensional views and multi-articulated moving instruments.Herein, we report our experience with the biportal approach of robot-assisted anterior mediastinal mass surgery, including both lateral transthoracic and subxiphoid approaches. Methods: We retrospectively analyzed 21 patients who underwent biportal robotic-assisted anterior mediastinal mass resection, without considering the tumor size between May 2018 and September 2022. We reviewed the technical advantages and limitations of the biportal approach and the perioperative outcomes, including operative time, conversion to multiport or open surgery, duration of chest drainage, and postoperative complications, to define the role of robot-assisted surgery using the biportal approach. Results: We approached the thoracic cavity from the right side in five patients, from the left side in three patients, and from the subxiphoid in 13 patients. Thymomas (n=13) and thymic cysts (n=3) were the most common diagnoses. The median operative time was 165 min [interquartile range (IQR), 140-196 min]. There were no conversions to multiport or open surgery. The chest drain was removed at a median of two days (IQR, 1-3 days), and the patients were discharged at a median of four days (IQR, 3-5 days).Perioperative complications were reported in two patients (one with prolonged air leak and one with vocal cord palsy). There were no cases of readmission or delayed complication. Conclusions:The biportal approach for robot-assisted surgery in anterior mediastinal masses is a feasible and safe alternative for treating associated pathologies. The subxiphoid approach for mediastinal surgery provides a better surgical view than the transthoracic approach. The biportal approach also enables the use of robotic staplers and energy devices and minimizes instrumental interference compared to that in the singleport approach.

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“…At present, some of these soft robots are in development, and the Flex Robotic System, is conducting human trials, particularly in the domain of transoral robotic surgery (34,35). As the robotic system evolves at a staggering pace, single-incision robotic chest surgery will be more and more widely applied in the years to come, resulting in safer, less painful, and superior efficacy operations for patients (36,37).…”

Section: Rats Systemmentioning

confidence: 99%

Video-assisted thoracoscopy for lung cancer: who is the future of thoracic surgery?

Jiang¹,

Su²,

Liang³

et al. 2020

J Thorac Dis

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Lung cancer is one of the most commonly diagnosed cancer with an estimated 228,820 new cases in 2020, representing 12.67% of all new cancer cases (1). According to a systemic global cancer study, lung cancer is the main cause for cancer deaths, with 1.9 million deaths worldwide (2). Due to the high incidence and mortality, lung cancer has become a heavy burden on public health. However, with the extensive use of low-dose computed tomographic screening, more patients with operable lung cancer (stages IA-IIIA) can be diagnosed at an early stage. Additionally, with the revolution of surgical interventions and development of chemotherapy and radiotherapy, the 5-year survival for lung cancer cases is

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Initial Experiences With Robotic Single-Site Thoracic Surgery for Mediastinal Masses

Cited by 15 publications

References 11 publications

Initial experience with and surgical outcomes of da Vinci single-port system in general thoracic surgery

Initial experience with and surgical outcomes of da Vinci single-port system in general thoracic surgery

Biportal robotic surgery for anterior mediastinal mass

Video-assisted thoracoscopy for lung cancer: who is the future of thoracic surgery?

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