Robotic lung resections: video-assisted thoracic surgery based approach

Toker, Alper; Kaba, Erkan; Ayalp, Kemal; Özyurtkan, Mehmet Oğuzhan

doi:10.21037/jovs.2017.01.08

Cited by 9 publications

(20 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, surgeons experienced in VATS may feel comfortable performing RAL owing to its similarities to the VATS technique. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…In our opinion, instead of the higher cost, the most important disadvantage of CPRL-4 is the need for surgical experience in robotic lobectomy, which can be assessed by RAL. [ 12 ] Table 3 shows a comparison of these two techniques.…”

Section: Discussionmentioning

confidence: 99%

“…The CPRL-4 uses CO 2 insufflation and a fourth robotic arm to create the workspace. [ 12 ] In our study, heated CO 2 (37°C) was used with a pressure <10 mmHg. While a higher CO 2 insufflation pressure provides a better view of the surgical field, pressure exceeding 10 mmHg may cause hypercarbia.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Robot-assisted lobectomy versus completely portal robotic lobectomy: What is the difference?

Akkuş

Seyrek

2020

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

Background: This study aims to compare robot-assisted lobectomy versus completely portal robotic lobectomy. Methods: Between January 2014 and December 2019, a total of 41 patients (10 males, 31 females; median age 62 years; range, 50 to 68 years) underwent robotic anatomical pulmonary resection in our institution were retrospectively analyzed. The patients were consecutively divided into two groups: the first 20 (48.8%) patients underwent pulmonary resection by robot-assisted lobectomy technique, while the next 21 (51.2%) patients underwent pulmonary resection by completely portal robotic lobectomy with four arms. Data including age, sex, diagnosis, surgery type and duration, rate of conversion to open surgery, and length of stay of the patients were recorded. The operation time, docking time, console time, and closure duration for each patient were also noted. Results: There was no statistically significant difference in age, sex, comorbidities, complications, length of hospital stay, adequate lymph node staging, or tumor size and side between the two groups (p>0.05). However, the mean console and operation times were statistically significantly shorter in the patients receiving completely portal robotic lobectomy with four arms (p=0.001). Conclusion: The advantage of completely portal robotic lobectomy with four arms is relative, although it significantly shortens the operation time. Based on our experiences, this technique may be preferred in case of inadequate lung deflation, as carbon dioxide insufflation allows sufficient workspace for robotic lung resection.

show abstract

“…Nevertheless, surgeons experienced in VATS may feel comfortable performing RAL owing to its similarities to the VATS technique. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Robot-assisted lobectomy versus completely portal robotic lobectomy: What is the difference?

Akkuş

Seyrek

2020

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

show abstract

“…The technique we described here was used for Da Vinci SI systems (Da Vinci System Intuitive Surgical, Sunnyvale, California, United States). 16…”

Section: Surgical Techniquementioning

confidence: 99%

Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary Resection

Cosgun

Kaba

Ayalp

et al. 2019

Thorac Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

Background Robot technology is a revolutionary technique to overcome limitations of minimal invasive surgery. The proficiency level varies from study to study. We considered the first sleeve lobectomy as a benchmark procedure to evaluate the proficiency level. Methods We retrospectively analyzed 197 patients who underwent robot-assisted thoracoscopic surgery (RATS) for primary lung cancer between December 2011 and May 2018. Patients were divided into two groups based on undergoing surgery earlier period (EP) or later period (LP) than the first sleeve lobectomy by RATS (May 25, 2015). The preoperative, operative, and short- and long-term postoperative outcomes were compared. Seven-year survival was also compared between two periods for T1N0 and T2N0 diseases. Results Preoperative features were similar. The mean operative time was 166.8 ± 55.1 and 142.4 ± 43.9 minutes in EP and LP, respectively (p = 0.005). The mean number of dissected lymph nodes in LP was also significantly higher than that in EP (24.4 ± 9.4 vs. 20.8 ± 10.4, p = 0.035). The complication rate was significantly lower in LP (29/86 vs. 25/111, p = 0.048). The extended resection (ER) rate was significantly higher in LP (p = 0.023). The 7-year survival was comparable in EP and LP in both patients with T1N0 and T2N0 (p = 0.28 and p = 0.11, respectively). Conclusion Perioperative outcomes, such as duration of surgery, number of dissected lymph nodes, complications, and ERs are favorable in patients who underwent surgeries after the first sleeve resection. The first sleeve lobectomy may be considered as the benchmark procedure for the proficiency level in RATS.

show abstract

“…When a fourth arm was used, it was placed lateral to the posterior arm. The technique we described here was used for Da Vinci SI systems (Da Vinci System Intuitive Surgical, Sunnyvale, CA, USA) [9] . The Da Vinci robotic system was used in 83 patients, while 75 underwent biportal VATS.…”

Section: Surgical Techniquementioning

confidence: 99%

Factors on nodal up-staging in clinical N0 adenocarcinoma patients who had minimally invasive anatomic lung resections

Cosgun¹,

Kaba²,

Ayalp³

et al. 2019

MIS

Self Cite

View full text Add to dashboard Cite

Aim: The incidence of adenocarcinoma among lung cancer patients has increased in recent years. We identified the factors affecting lymph node status in patients with primary lung adenocarcinoma who underwent minimallyinvasive anatomic resection. Methods: We retrospectively analyzed the medical records of primary lung adenocarcinoma patients who underwent minimally-invasive anatomic lung resections and mediastinal lymph node dissection between January 2012 and December 2017. We evaluated lymph node positivity and nodal status in each T and histologic subgroup, tumoral prognostic characteristics, minimally-invasive surgical methods and resection type. Results: Of 473 patients who underwent anatomic resection for lung cancer between January 2012 and December 2017, 274 underwent minimally-invasive anatomic lung resections for primary lung cancer, 158 adenocarcinoma patients were analyzed in this study. Nodal status and number of positive lymph nodes were similar in the stages T1, T2, T3. Lymphovascular invasion (n : 78) and micropapillary predominance tended to be significant predisposing factors for lymph node metastasis. Mean dissected lymph node number was significantly higher in patients who underwent Robot-assisted thoracoscopic surgery compared to Video-assisted thoracoscopic surgery (P < 0.05), and in those who underwent lobectomy compared to segmentectomy (P < 0.05). Conclusion: We were unable to demonstrate a relationship between T stage and N status. Factors contributing to unexpected N positivity were tumor characteristics that could not be identified in the preoperative period. We recommend performing systematic mediastinal lymph node dissection regardless of the size and histopathologic type of adenocarcinoma. In our study, robotic surgery and lobectomy operation showed superiority in dissecting more lymph nodes.

show abstract

Robotic lung resections: video-assisted thoracic surgery based approach

Cited by 9 publications

References 14 publications

Robot-assisted lobectomy versus completely portal robotic lobectomy: What is the difference?

Robot-assisted lobectomy versus completely portal robotic lobectomy: What is the difference?

Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary Resection

Factors on nodal up-staging in clinical N0 adenocarcinoma patients who had minimally invasive anatomic lung resections

Contact Info

Product

Resources

About