Intraoperative Anesthetic and Surgical Concerns for Robotic Thoracic Surgery

Video clip is available online. Feature Editor's Introduction-Welcome to the beginning of a series of new format articles in JTCVS Techniques termed Video Atlas Articles (VAAs). VAAs are peerreviewed descriptions of a surgical procedure crystallized into a series of steps, with each step taught through its own narrated video and corresponding short text. The purpose of the VAA series is to provide continuing surgical education in an enduring format. Quality is maintained by the invitation of expert authors and by the iterative peer-review process involving expert reviewers. Thoracic surgeons are privileged to care for patients with a vast breadth and depth of conditions using an expansive armamentarium of rapidly evolving techniques. Most thoracic surgeons will perform operations they had never before performed in their training, and many will become expert in them. In fact, an entire generation of thoracic surgeons learned robotic thoracic surgery without residency or fellowship training on the robot, and surgeons from this generation are the current leaders in robotic thoracic surgery. This field is fastpaced and rapidly evolving. To provide the highest level of care to our patients, to embrace (and drive) the exciting innovation in our field, and sometimes even to remain relevant in the field of thoracic surgery requires the surgeon's effort in self-learning. There are many modalities for continuing surgical education; however, with regard to technique, there is little substitute for the first-hand experience of observing an expert surgeon operating, for junior and seasoned surgeons alike. The VAA is designed to replicate this experience in a quality-assured, on-hand, and high-impact format. Robotic right upper lobectomy is an index operation of the modern thoracic surgeon, and herein it is professionally illustrated in a VAA.

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“…No arterial line or urinary catheter is placed for the procedure. 2 The right upper lobectomy is performed in the following 12 steps:…”

Section: Resultsmentioning

confidence: 99%

Robotic right upper lobectomy: Twelve steps

2021

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“… 10 We repeat the CXR in 2 to 4 hours, and if there was no increase to the pneumothorax, the patient remained clinically stable, and there was no new or increasing subcutaneous emphysema, we did not intervene except to add nasal cannula oxygen. Additionally, our oral pain management regimen, as previously reported, 11 consisted of acetaminophen, gabapentin, ibuprofen, and oxycodone as needed.…”

Section: Methodsmentioning

confidence: 99%

The process and safety of removing chest tubes 4 to 12 hours after robotic pulmonary lobectomy and segmentectomy

McCormack,

El Zaeedi,

Geraci

et al. 2023

JTCVS Open

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“…This flexibility can help improve the trainee's confidence and lessen the primary surgeon's concerns or frustrations. Finally, the robotic technology allows for video recordings of the operation to be easily saved, which can enhance teaching through later review and critique of operative conduct (16).…”

Section: Transitioning To a Robotic Thoracic Program: Why Do It?mentioning

confidence: 99%

Transitioning to robotics in a successful thoracoscopic and laparoscopic thoracic program: why do it, and how?

Yousef¹,

Luketich²,

Sarkaria³

2023

J Vis Surg

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Background: the rise of robotics in thoracic surgeryThe robotic surgical platform has been embraced with impressive speed over the past few decades, despite initial skepticism from many surgeons. Computer Motion's initial robot, "Zeus", while a revolution in its time, had many limitations, particularly in articulation. This limited the utility of the robotic platform in complex operations and fueled early skepticism. However, while "Zeus" was approved for a limited number of clinical trials, Computer Motion's competitor, Intuitive Surgical, was soon to release their robotic platform, with several key technologic advances. The two companies merged in 2003 leading to overall improved technology. Intuitive Surgical's "Davinci" system emerged as the clinical forerunner for nearly two decades as more advanced versions of the platform were introduced. The skills required to complete complex cases with the Davinci were soon acquired by an increasing number of surgeons, and, today, robotic-assisted surgery with the Davinci has become the new "norm" in many centers.The robotic platform has been utilized in thoracic surgery for over 20 years, with one of the first reported

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Intraoperative Anesthetic and Surgical Concerns for Robotic Thoracic Surgery

Cited by 4 publications

References 20 publications

Robotic right upper lobectomy: Twelve steps

Robotic right upper lobectomy: Twelve steps

The process and safety of removing chest tubes 4 to 12 hours after robotic pulmonary lobectomy and segmentectomy

Transitioning to robotics in a successful thoracoscopic and laparoscopic thoracic program: why do it, and how?

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