Robotic Sleeve Resection of the Airway: Outcomes and Technical Conduct Using Video Vignettes

Geraci, Travis C.; Ferrari-Light, Dana; Wang, Simeng; Mitzman, Brian; Chang, Stephanie H.; Kent, Amie J.; Pass, Harvey I.; Bizekis, Costas; Zervos, Michael; Cerfolio, Robert J.

doi:10.1016/j.athoracsur.2020.01.077

Cited by 16 publications

(15 citation statements)

References 10 publications

(17 reference statements)

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“…Multiple institutional series on robotic sleeve lobectomy report R0 resection rates and lymphadenectomy quality similar to open sleeve resection. [7][8][9][10] In fact, several studies have also found increased lymph node removal and nodal upstaging with a robotic approach as compared with thoracoscopic (videoassisted thoracoscopic surgery [VATS]) or open lobectomy. [11][12][13][14][15] Qui et al recently performed a propensity score analysis of robotic sleeve lobectomy compared with VATS and open surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple institutional series have demonstrated the safety and efficacy of a robotic approach for segmentectomy, sleeve lobectomy, and other complex tracheobronchial reconstructions. [3][4][5][6][7] We describe our approach to complex pulmonary cancer resections, with a case scenario and accompanying video of a right upper lobe sleeve lobectomy to highlight operative details and anatomic considerations during resection (Supplemental Video).…”

Section: Introductionmentioning

confidence: 99%

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Robotic-Assisted Complex Pulmonary Resection: Sleeve Lobectomy for Cancer

Watkins

Quadri

Servais

2021

Innovations�(Phila)

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The use of robotic assistance for complex pulmonary resections such as segmentectomy and sleeve lobectomy has steadily increased in recent years. These operations are technically challenging as they require fine dissection and suturing, which is often difficult to perform using traditional minimally invasive techniques. Robotic surgery is well-suited for complex pulmonary surgery given its specific advantages related to superior optics and precise tissue manipulation and dissection. Herein we describe our technique for robotic-assisted complex pulmonary surgery with a specific focus on right upper sleeve lobectomy for cancer, including associated video case demonstration. The principles discussed are generalizable to other complex lung and tracheobronchial operations and highlight the benefits of the robotic platform.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic-Assisted Complex Pulmonary Resection: Sleeve Lobectomy for Cancer

Watkins

Quadri

Servais

2021

Innovations�(Phila)

View full text Add to dashboard Cite

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“…In our experience, a 4-arm totally endoscopic approach is utilized with an assist port and bedside assistant (9). The conduction of the operation begins with a complete lymph node dissection.…”

Section: Sleeve Lobectomymentioning

confidence: 99%

Beyond the learning curve: a review of complex cases in robotic thoracic surgery

Geraci¹,

Scheinerman²,

Chen³

et al. 2021

J Thorac Dis

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The number of thoracic surgery cases performed on the robotic platform has increased steadily over the last two decades. An increasing number of surgeons are training on the robotic system, which like any new technique or technology, has a progressive learning curve. Central to establishing a successful robotic program is the development of a dedicated thoracic robotic team that involves anesthesiologists, nurses, and bed-side assistants. With an additional surgeon console, the robot is an excellent platform for teaching. Compared to current methods of video-assisted thoracoscopic surgery (VATS), the robot offers improved wristed motion, a magnified, high definition three-dimensional vision, and greater surgeon control of the operation. These advantages are paired with integrated adjunctive technology such as infrared imaging. For pulmonary resection, these advantages of the robotic platform have translated into several clinical benefits, such as fewer overall complications, reduced pain, shorter length of stay, better postoperative pulmonary function, lower operative blood loss, and a lower 30-day mortality rate compared to open thoracotomy. With increased experience, cases of greater complexity are being performed. This review article details the process of becoming an experienced robotic thoracic surgeon and discusses a series of challenging cases in robotic thoracic surgery that a surgeon may encounter "beyond the learning curve". Nearly all thoracic surgery can now be approached robotically, including sleeve lobectomy, pneumonectomy, resection of large pulmonary and mediastinal masses, decortication, thoracic duct ligation, rib resection, and pulmonary resection after prior chest surgery and/or chemoradiation.

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“…Nonetheless, indication for robotic approach progressively broadened to more advanced disease requiring complex procedures, such as surgery for Pancoast tumor, bronchoplastic procedures and double-sleeve lobectomies (27)(28)(29)(30)(31)(32).…”

Section: Robotic Surgery For Locally Advanced Nclc: Literature Reviewmentioning

confidence: 99%

Robotic surgery for locally advanced non-small cell lung cancer

Muriana¹,

Perroni²,

Novellis³

et al. 2021

J Vis Surg

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Stage III non-small cell lung cancer (NSCLC) is a heterogeneous group of diseases including large masses, mediastinal lymph node involvement, and invasion of major mediastinal structures. Robotic surgery is a minimally invasive approach recognized as an equivalent alternative to open surgery in case of early stage NSCLC. An increasing number of studies also assert that robotics is a reasonable option for the treatment of locally advanced disease in the setting of multimodality therapy. Major advantages of the technique are increased radicality compared to video-assisted thoracic surgery (VATS), fast postoperative recovery and better compliance to adjuvant therapies compared to open. In this paper we present some technical aspects of the robotic lobectomy in locally advanced disease, we discuss different robotic approaches and review the literature of robotic treatment of lung cancer patients. To describe the technique, we use two case studies of patients affected by locally advanced NSCLC operated with robotic surgery. A patient with right upper lobe (RUL) pulmonary adenocarcinoma and single N2-station metastasis underwent robotic lobectomy following response to induction chemo-radiotherapy. A radical excision of the tumor was obtained with clear margins and no evidence of residual disease at pathologic examination. In the second case, a diagnosis of N2 lymph node metastasis (station R4) from pulmonary adenocarcinoma was made in a patient with primary occult tumor. After induction treatment, the patient underwent robotic radical mediastinal lymph node dissection with curative intent. Unexpected partial invasion of the wall of superior vena cava (SVC) was safely managed with tangential resection. Despite the problems of costs, availability, and learning curve, the Authors believe that robotic surgery has indisputable advantages to obtain a radical resection in case of locally advanced NSCLC.

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Robotic Sleeve Resection of the Airway: Outcomes and Technical Conduct Using Video Vignettes

Cited by 16 publications

References 10 publications

Robotic-Assisted Complex Pulmonary Resection: Sleeve Lobectomy for Cancer

Robotic-Assisted Complex Pulmonary Resection: Sleeve Lobectomy for Cancer

Beyond the learning curve: a review of complex cases in robotic thoracic surgery

Robotic surgery for locally advanced non-small cell lung cancer

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