Robotic lobectomy

Abstract

Lobectomy is still currently the gold standard for treatment of lung cancer. With the great advancement of robotic surgery, robotic lobectomy has been demonstrated to be an operation that is safe and can be done in a timely manner, similar to video-assisted thoracoscopic surgery (VATS). Additionally, reports show that long-term oncologic outcomes for robotic lobectomy are consistent with those reported for VATS and open lobectomy. Patients are selected in the same manner as those for VATS. Improved optics, increased dexterity of the instruments, and better ergonomics can yield subjective advantages to the surgeon. The techniques of port placement, mediastinal lymph node dissection and the steps of each of the five lobectomies are important and described in the chapter, for both the da Vinci Si and da Vinci Xi platforms. The subtle differences are highlighted. Additionally, advantages of the platforms are discussed.

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

“…Robotic lobectomy may be indicated in patients with marginal pulmonary function and locally advanced cancer [ 24 , 25 ]. Generally, some conditions such as dense adhesions, bronchial invasion, chest wall invasion, hilar nodal invasion, preoperative radiotherapy, prior thoracic surgery, and hilar nodal invasion are no longer regarded as absolute contraindications; instead, they are considered relative contraindication [ 4 , 26 ]. In our opinion, robotic lobectomy by an experienced surgeon is feasible in these patients.…”

“…Traditionally, it was performed via an open thoracotomy approach, which is associated with severe postoperative pain and a large wound. Minimally invasive thoracic surgery lobectomy, including video-assisted thoracic surgery (VATS) and robotic lobectomy, has been considered an appropriate approach and is associated with low perioperative morbidity, less pain, shorter hospitalization, and equivalent oncologic outcomes compared with open thoracotomy [ 1 - 5 ].…”

10 Commandments of Robotic Lobectomy

“…[1][2][3] Robotic lobectomy offers improved dexterity, enhanced precision, and augmented visualization, which is likely why robotic lobectomy is associated with improved patient morbidity. 4 Despite advances, the learning curve associated with robotic lobectomy is steep for both experienced and inexperienced robotic surgeons. Mastery of robotic lobectomy is facilitated by a comfort of the anatomy and a mastery of basic, yet critical, concepts.…”

Robotic total knee arthroplasty

“…Over the following two decades, several other surgical robotic devices were developed, including the Zeus (Computer Motion, Inc., Goleta, California) and Da Vinci (Intuitive Surgical, Sunnyvale, California) robotic platforms, which enabled a variety of surgical procedures to be performed remotely using robotically controlled arms and a 3D camera to improve the visual field. 5,6 These robotic devices have been used to perform cholecystectomy, hysterectomy, lobectomy, mitral valve replacement, coronary artery bypass grafting, and prostatectomy. Compared with conventional open surgery or laparoscopic surgery, robotic surgery with these devices is associated with smaller skin incisions, improved precision of soft-tissue dissection, better visualization of the surgical field, and more comprehensive data capture for surgical training.…”

“…Compared with conventional open surgery or laparoscopic surgery, robotic surgery with these devices is associated with smaller skin incisions, improved precision of soft-tissue dissection, better visualization of the surgical field, and more comprehensive data capture for surgical training. 6,7 Clinically, this has translated to robotic surgery enabling faster postoperative rehabilitation and decreased length of hospital stay compared with conventional and laparoscopic surgery for these procedures. 5-8…”