Robot-Assisted Thoracic Surgery in Non-small Cell Lung Cancer

Lee, Jun Hee; Hong, Jeong In; Kim, Hyun Koo

doi:10.5090/jcs.21.070

Cited by 6 publications

(10 citation statements)

References 36 publications

(46 reference statements)

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“…Roll-up gauze is also useful for replacing suction devices or traction, and its usefulness has been described in our previous studies. 2,8 Another limitation is that the target lesion should be at least 10 cm away from the tip of the SP cannula due to the technical limitations of the SPS. Lesions close to the subcostal incision are difficult to access.…”

Section: Discussionmentioning

confidence: 99%

Single‐port robotic subcostal major pulmonary resection using the single‐port robotic system

Lee,

Hong,

Kim

2024

World j. surg.

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BackgroundThe da Vinci single‐port system (SPS) (Intuitive Surgical, Sunnyvale, CA, USA) was designed for single‐port (SP) surgery. Although we have reported our clinical outcomes using the SPS for a simple procedure in general thoracic surgery, major pulmonary resection had been performed only in cadaveric experiments to date. This study evaluated the feasibility of SP subcostal robotic major pulmonary resection using the SPS. Here, we present our initial clinical experience of SP subcostal robotic major pulmonary resection at our institution.MethodsTwenty‐five patients with lung cancer underwent SP major subcostal pulmonary resection using the SPS between March and November 2022. Patient characteristics, intraoperative and perioperative outcomes were assessed. Questionnaires were used to evaluate patient satisfaction with the cosmetic results and quality of life through face‐to‐face or telephone interviews on postoperative day 30.ResultsAll patients underwent major pulmonary resection with complete radical resection (R0). Nineteen patients underwent lobectomy, whereas six patients underwent segmentectomy. The mean docking time and total operative time were 4.16 ± 1.19 min (range, 2.3–7.8 min) and 197.6 ± 55.33 min (range, 130–313 min), respectively. No patients underwent conversion to open thoracotomy. One patient required an additional assistant port due to severe pleural adhesions.ConclusionsSP subcostal robotic major pulmonary resection using the SPS is feasible and safe. With the continuous development of robotic technology and surgical techniques, we believe that more complex general thoracic surgeries will be performed in the future using SPS.

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Section: Discussionmentioning

confidence: 99%

Single‐port robotic subcostal major pulmonary resection using the single‐port robotic system

Lee,

Hong,

Kim

2024

World j. surg.

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“…Furthermore, to compensate for such restrictions, usually, a rolled‐up gauze is placed between the robot wrist and the tissue to be retracted at our institution. This technique makes it possible to retract the tissue during dissection without the 4 th robotic arm or the assistant during most of the surgery [19].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two‐Port and Three‐Port Approaches in Robotic Lobectomy for Non‐Small Cell Lung Cancer

et al. 2022

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Background Robot-assisted lobectomy has been used to treat non-small cell lung cancer and usually uses 3 or 4 ports and 3 or 4 robotic arms. We recently developed a two-port approach for robotic lobectomy using three robotic arms and performed a propensity score-matched analysis to compare the feasibility of the two-port and three-port techniques. Methods Data on robotic lobectomy for non-small cell lung cancer were retrospectively reviewed. Patients were matched using propensity score based on age, sex, smoking, diabetes, hypertension, forced expiratory volume per 1 s, neoadjuvant chemotherapy, clinical stage, lobe involved, tumor size, and cell types. Overall, 53 and 89 patients who underwent the two-port and three-port approaches, respectively, were matched (1:1 ratio; caliper distance, 0.2). We analyzed the perioperative outcomes and postoperative pain to evaluate the feasibility and safety. ResultsThe matched group included 37 patients each who underwent two-port and three-port robotic lobectomy. The operation time was shorter in the two-port group (P = .01). The number of lymph nodes resected (P = .70), conversion to multiport or thoracotomy (P [ .99), morbidity and mortality (P = .31), drain indwelling time (P = .32), and hospital stay (P = .11) were not significantly different between the groups. The postoperative pain was less at 0-3 postoperative days (P \ .01) in the two-port group. The total medical cost was not markedly increased after transitioning to the two-port technique. Conclusions Two-port approach in robotic lobectomy is a safe and feasible alternative approach for treating nonsmall cell lung cancer.

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“…In addition, as shown in the lung cancer survival curve of this study, surgical treatment—even with pneumonectomy in the 20- to 60-year age group—could achieve reasonable survival. Various efforts to improve clinical outcomes and expand surgical indications may have produced these results [ 11 - 13 , 20 - 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Smoking cessation [ 6 ], early diagnosis of lung cancer [ 7 ], new drugs [ 8 ], and surgery [ 9 ] have shown survival benefits in lung cancer. Of these, surgery is still the most effective treatment for early-stage lung cancer [ 10 ], and its clinical outcomes have improved with the wide use of video or robot-assisted thoracic surgery [ 11 , 12 ]. Moreover, the indications for surgery have increased with the adoption of segmentectomy, which might show comparable outcomes to lobectomy in small lung cancers [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Current Status of Lung Cancer and Surgery Based on Studies Using a Nationwide Database

Kim

Lee

2022

J Chest Surg

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Lung cancer is a fatal disease, highlighting the importance of research on related topics, including surgery for lung cancer. However, systematic research analyzing surgery on a national scale is limited. This study aimed to investigate the research on lung cancer using nationwide data in South Korea and to analyze trends in lung cancer surgery, including its clinical implications. Published articles and data from the Korean National Health Insurance database were used. Although the incidence and mortality of lung cancer have been improving, it is predicted to be the most common and fatal type of cancer in South Korea in 2021. The number of surgical procedures for lung cancer is increasing, especially among women, those ≥76 years of age, residents of non-metropolitan cities, and middle-income patients. Lobectomy and sublobectomy, including segmentectomy, are increasingly common. However, the proportion of pneumonectomy relative to other procedures is not increasing. Surgery has shown a reasonable survival rate, especially after lobectomy, but survival remains poor in patients ≥76 years of age who undergo pneumonectomy. The frequency of lung cancer surgery is increasing concomitantly with various socioeconomic changes. Lobectomy has become increasingly common, and the clinical results of surgery are satisfactory. Further research on the changing composition of surgical candidates is required.

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Robot-Assisted Thoracic Surgery in Non-small Cell Lung Cancer

Cited by 6 publications

References 36 publications

Single‐port robotic subcostal major pulmonary resection using the single‐port robotic system

Single‐port robotic subcostal major pulmonary resection using the single‐port robotic system

Comparison of Two‐Port and Three‐Port Approaches in Robotic Lobectomy for Non‐Small Cell Lung Cancer

Current Status of Lung Cancer and Surgery Based on Studies Using a Nationwide Database

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