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Robotic lobectomy

Federico Davini, Sara Ricciardi, Carmelina Cristina Zirafa, Ilenia Cavaliere, Gaetano Romano, Franca Melfi
Background: The incidental detection of solitary pulmonary nodule (SPN) is currently increasing due to the widespread use of computed tomography (CT) during the follow up in oncological patients or in screening trials. A quick and definitive histological diagnosis of these nodes is mandatory as, in case of primitive lung cancer, an early detection could improve both surgical results and prognosis. The minimally invasive pulmonary resection (MIPR) is the gold standard procedure for diagnosis and treatment of small lung nodules, but it can be difficult to localize deep nonpalpable nodes that lie in the lung parenchyma...
2018: Journal of Visualized Surgery
Sophia Chen, Travis C Geraci, Robert James Cerfolio
Robotic lobectomy is an increasingly common surgical approach for anatomic lung resection. Over the last decade, robotic lobectomy has shown to be safe, with oncologic efficacy similar to lobectomy via thoracotomy or video-assisted thoracoscopic surgery (VATS). Comparative analysis between these modalities is an active area of investigation. While initially expensive, the costs of a robotic platform decrease as the number of operations performed increases, length of stay is shortened, and postoperative morbidity is reduced...
March 5, 2018: Expert Review of Respiratory Medicine
Shruti Jayakumar, Marco Nardini, Pavlos Papoulidis, Joel Dunning
We present the case of a 74-year-old man with Stage IIa pulmonary adenocarcinoma, for which he underwent a robotic right middle lobectomy. A 4-armed, 5-port approach was used. Four intercostal ports were created above the ninth rib using the Cerfolio's technique. The subxiphoid port was created in the midline, 5 cm down from the xiphisternum. The robot offers higher image quality, depth perception and improved articulation of the instruments, allowing for more accurate dissection and stitching. The usage of a subxiphoid utility port reduces the clashing between instruments, offers a good angle for stapling and provides a direct view of the instruments entering into the chest...
January 23, 2018: Interactive Cardiovascular and Thoracic Surgery
Benjamin Smood, Asem Ghanim, Benjamin Wei, Robert J Cerfolio
The objectives of this study are to review the complicated and often confusing technical changes required when converting from the Si robotic system to the Xi when performing pulmonary lobectomy and segmentectomy. We reviewed a prospective database of a consecutive series of patients who intended to undergo robotic lobectomy or segmentectomy by one surgeon. There were 101 lobectomies and 25 segmentectomies performed on the Si robot in 2015-2016, and 95 lobectomies and 28 segmentectomies in 2016 on the Xi robot...
January 23, 2018: Journal of Robotic Surgery
Eon-Bin Kim, Jae Won Cho, Yu-Mi Lee, Tae-Yon Sung, Jong Ho Yoon, Ki-Wook Chung, Suck Joon Hong
BACKGROUND: Advanced technology and understanding of robotic surgical system have rendered robotic thyroid surgery more expanding. The aim of this study was to identify the periodic changes in postsurgical outcomes of robotic thyroid surgery performed by a single surgeon. METHODS: We conducted a retrospective review of 700 robotic thyroid surgery cases using gasless trans-axillary approach. RESULTS: All patients underwent successful operations without conversion to open surgery, and were mostly younger than 45 years, female, less-extended thyroid surgery and lymph node dissection, and thyroid cancer...
January 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Min P Kim, Edward Y Chan
Early versions of the da Vinci robot system (S and Si) have been used to perform pulmonary lung resection with severe limitations. The lack of a vascular robot stapler required the presence of a trained bedside assistant whose role was to place, manipulate and fire the stapler around major vascular structures. Thus, the techniques developed for the Si robot required a skilled bedside assistant to perform stapling of the hilar structure and manipulation of the lung. With the advent of the da Vinci Xi system with a vascular robot stapler, we postulated that we could develop a new port placement and technique to provide total control for the surgeon during the pulmonary lung resection...
December 2017: Journal of Thoracic Disease
Alessandro Pardolesi, Luca Bertolaccini, Jury Brandolini, Piergiorgio Solli
Numerous published articles have shown the safety and efficacy of robotic lung resection, including lobectomy. Several techniques have been described by different authors to perform a robot assisted lung lobectomy. We adopted four arms robotic procedure. We usually perform three ports (10-15 mm) and an anterior 3 to 4 cm utility incision. This technique allows to safely proceed with an anterior to posterior approach to the hilum. In this study, we present in clear and sequential steps, the procedure to perform a right upper lobectomy for early stage lung cancer...
September 2017: Journal of Thoracic Disease
Abbas E Abbas
No abstract text is available yet for this article.
September 2017: Journal of Thoracic Disease
Jules Lin
No abstract text is available yet for this article.
September 2017: Journal of Thoracic Disease
Chang Myeon Song, Youn Il Jang, Yong Bae Ji, Jeong Seon Park, Dong Sun Kim, Kyung Tae
BACKGROUND: The purpose of this study was to evaluate factors related to operative time in robotic thyroidectomy. METHODS: We retrospectively analyzed 240 patients who underwent robotic thyroidectomy. The total thyroidectomy cases and lobectomy cases were both categorized into those with long operative times (LOTs; upper 25% of cases) and those with short operative times (SOTs; lower 25%). RESULTS: Among the total thyroidectomy cases, body mass index (BMI) ≥23 kg/m2 (hazard ratio [HR] 5...
December 5, 2017: Head & Neck
Mohamed K Kamel, Jeffrey L Port
PURPOSE OF REVIEW: Elderly patients presenting with thoracic malignancies tend to be largely undertreated because of a presumption that this group will incur a high treatment-associated morbidity and mortality. The current review highlights the current practice and recent updates in the surgical management of thoracic malignancies, mainly lung cancer, in the elderly population. RECENT FINDINGS: Lung resections appears to be relatively safe in the elderly patients presenting with lung cancer...
February 2018: Current Opinion in Anaesthesiology
Paul Linsky, Benjamin Wei
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...
2017: Journal of Visualized Surgery
Sara Ricciardi, Giuseppe Cardillo, Carmelina Cristina Zirafa, Federico Davini, Franca Melfi
During the last decade, an abundance of papers has supported minimally invasive pulmonary resections (MIPR) vs. traditional open approach. Both video assisted thoracic surgery (VATS) and robotic thoracic surgery have shown better perioperative outcomes and equivalent oncologic results compared with thoracotomy, confirming the effectiveness of the MIPR. Despite the profound changes and improvements that have taken place throughout the years and the increasing use of robotic system worldwide, the controversy about the application of robotic surgery for lung resections is still open...
2017: Journal of Visualized Surgery
Giulia Veronesi, Pierluigi Novellis, Orazio Difrancesco, Mark Dylewski
Some series report the use of video-assisted thoracic surgery (VATS) in patients with locally advanced non-small cell lung cancer (NSCLC) but, few studies describe the use of the robotic approach specifically for locally advanced disease. One potential advantage of the robotic approach over traditional VATS is the increased radicality. While the benefit of the robotic approach over open thoracotomy is directly related to reduced surgical trauma and the improved tolerability in fragile patients that have received induction treatment...
2017: Journal of Visualized Surgery
Benedetta Bedetti, Philipp Schnorr, Joachim Schmidt, Marco Scarci
During the last three decades, minimally invasive surgery has become common practice in all kinds of surgical disciplines and, in Thoracic Surgery, the minimally invasive approach is recommended as the treatment of choice for early-stage non-small cell lung cancer. Nevertheless, all over the world a large number of lobectomies is still performed by conventional open thoracotomy and not as video-assisted thoracic surgery (VATS), which shows the need of a proper training for this technique. Development and improvement of surgical skills are not only challenging and time-consuming components of the training curriculum for resident or fellow surgeons, but also for more experienced consultants learning new techniques...
2017: Journal of Visualized Surgery
Takashi Suda
The "da Vinci Surgical System" is a robotic surgical system that utilizes multi-jointed robotic arms and a high-resolution three-dimensional video-monitoring system. We report on the state of transition from video-assisted thoracoscopic surgery (VATS) to robotic pulmonary surgery, the surgical outcomes of robotic surgery compared to VATS, and the future of robotic surgery. Surgery utilizing the da Vinci Surgical System requires a console surgeon and assistant who have been certified by Intuitive Surgical, Inc...
2017: Journal of Visualized Surgery
Marco Nardini, Marcello Migliore, Shruti Jayakumar, Mohamed ElSaegh, Izanee M Mydin, Joel Dunning
No abstract text is available yet for this article.
2017: Journal of Visualized Surgery
Mehmet Oğuzhan Özyurtkan, Erkan Kaba, Alper Toker
A surgeon needs to perform a sufficient number of procedures to achieve a level of proficiency. Learning curves demonstrate ongoing improvement in efficiency over the course of a surgeon's carrier. When the surgeon learns the procedure, this means that he has the ability to perform that procedure safely and effectively. The instruction of the da Vinci Surgical System (Initiative Surgical, Sunnyvale, CA, USA) provoked the need for preparing surgeons for complex robotic skills. As low as 5 repetitions are enough to achieve proficiency on basic robotic skills...
2017: Journal of Visualized Surgery
Daniel S Oh, Rishindra M Reddy, Madhu Lalitha Gorrepati, Shilpa Mehendale, Michael F Reed
BACKGROUND: Robotic-assisted lobectomy (RL) is becoming a popular alternative technique to video-assisted thoracoscopic lobectomy (VL), although open lobectomy (OL) remains the most common approach. The objective of this study is to provide a comparative analysis of perioperative clinical outcomes from elective RL, VL, and OL. METHODS: The Premier Healthcare Database was analyzed for lobectomies performed from January 1, 2011, to September 30, 2015. International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and procedure codes were used to identify surgical approaches, complications, and mortality...
November 2017: Annals of Thoracic Surgery
June Yi-Ling Low, Marco Nardini, Cristina Zirafa, Franca Melfi
We report an incidental discovery of the superior pulmonary vein coming from a strange anatomical location when performing a robotic left lower lobectomy. When trying to identify the superior pulmonary vein, an aberrant pulmonary vein was found leading into the innominate vein.
September 14, 2017: Interactive Cardiovascular and Thoracic Surgery
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