Video-Assisted Thoracic Surgery Lobectomy With Bronchoplasty for Lung Cancer: Initial Experience and Techniques

Nakanishi, Kozo

doi:10.1016/j.athoracsur.2007.03.008

Cited by 59 publications

(54 citation statements)

References 12 publications

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“…However, in these three patients, the postoperative course and hospital stay were similar to those of the other group. Nakanishi reported his early experience of performing VATS sleeve lobectomy and bronchoplasty on five patients in 2007 (8). The mean operation time was 552.4 (range, 330-740) minutes.…”

Section: Discussionmentioning

confidence: 99%

“…However, the application of VATS for locally advanced, centrally located lung cancers remains controversial. VATS sleeve lobectomy or bronchoplasty for locally advanced lung cancers has been sporadically reported (8,9), but its feasibility is limited because of its limited field of vision and maneuverability of instrumentation. In contrast, robotic surgery does allow for clear three-dimensional vision of the surgical field and provides ample maneuverability with its highly articulated robotic forceps.…”

Section: Discussionmentioning

confidence: 99%

“…VATS sleeve lobectomy or bronchoplasty has been reported, but its suitability is limited (8,9). The RATS platform may be superior to VATS for such complex thoracic surgeries because of its threedimensional viewing camera and articulated robotic forceps.…”

Section: Introductionmentioning

confidence: 99%

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Robotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer

et al. 2016

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Background: The Da Vinci robotic system has been used to enhance the surgeon's visualization and agility in lung cancer surgery, and thus facilitate refined dissection, knot tying and suturing. However, only a few case reports exist on performing a sleeve lobectomy with a robotic-assisted thoracoscopic surgery (RATS) technique. Here we describe our early experience performing RATS sleeve lobectomies. To our knowledge, this is the first study reporting a series of RATS sleeve lobectomies. Methods: The six consecutive NSCLC patients who underwent a RATS sleeve lobectomy betweenNovember 2013 and July 2015 at the National Taiwan University Hospital were enrolled in this study. The lobectomies were all performed by the same surgeon using a three-arm robotic system with an additional utility incision made for assistance and specimen retrieval.Results: Five patients were diagnosed with squamous cell carcinoma, while the sixth was diagnosed with a carcinoid tumor. The mean operation time was 436.7 [255-745] minutes. The mean postoperative intensive care unit (ICU) stay and hospital stay were 3.7 [1-11] and 11.3 [3-26] days, respectively. Two (33.3%; 2/6) morbidities were noted, including one pneumonia and one anastomosis stricture. There were no cases of mortality or of conversion to thoracotomy. Conclusions:Our experience performing a RATS sleeve lobectomy in the six patients demonstrated the feasibility of RATS in complex lung cancer surgeries. The three-dimensional vision and articulated joint instruments made robotic-assisted bronchial anastomosis easier under the endoscopic setting. Our experience suggests that RATS offers specific advantages with regard to accuracy and safety when performing sleeve lobectomies. endowrist technology. On the other hand, opponents of robotic surgery have cited the expensive cost, loss of haptic feedback, longer procedure times and concern regarding the management of accidental intraoperative bleeding (5-7). The impact of RATS lobectomy on clinical outcomes remains unclear. A few studies have reported on early experiences of using RATS for lung resection, and all have indicated similar outcomes in comparison with using VATS (5-7). Potential benefits may be postoperative pain reduction, early return to usual activity (5), and fewer conversions for uncontrolled bleeding (7). KeywordsCompared with standard lobectomy or wedge resection, the surgical technique of sleeve lobectomy is more complex, which has limited the usage of minimally invasive surgery in performing the procedure. VATS sleeve lobectomy or bronchoplasty has been reported, but its suitability is limited (8,9). The RATS platform may be superior to VATS for such complex thoracic surgeries because of its threedimensional viewing camera and articulated robotic forceps. However, there have been only three studies on the use of RATS for performing bronchoplasty or sleeve lobectomy (10-12). Here, we report our early experience conducting six RATS sleeve lobectomies for locally advanced lung cancer. This is the first series re...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Robotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer

et al. 2016

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“…However, central lung cancer was still considered a contraindication of thoracoscopic surgery (11,12). Thoracoscopic bronchial sleeve resection has only been reported in limited studies (13)(14)(15)(16). This report describes a minimally invasive technique for VATS right upper lobe bronchial sleeve resection.…”

Section: Introductionmentioning

confidence: 99%