Skip to main content

Advertisement

Log in

Robotically assisted thymectomy: a review of the literature

  • Review Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

The aim of this literature review is to see where the robotic thymectomy stands nowadays. A thorough search of the PubMed revealed eighty-two related articles which reviewed comprehensively. The zero intraoperative mortality, the minimal intraoperative morbidity, as well as the recorded recurrence rate of 0–11.1% and complete stable remission rate of 0–40% suggests that the robotic-assisted thymectomy is a feasible, safe and an upcoming procedure. However, the lack of prospective randomized controlled trials prevents this technique to become the standard approach for the nonce.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Surgery of the Thymus Gland: Historical Review, Embryology, Anatomy. Available at http://emedicine.medscape.com/article/427053-overview. Accessed 16 April 2016

  2. Al-Githmi I (2011) Robotic-assisted thymectomy in patients with nonthymomatous myasthenia gravis. Surg Sci 02(393):396

    Google Scholar 

  3. Weksler B, Tavares J, Newhook T, Greenleaf C, Diehl J (2011) Robot-assisted thymectomy is superior to transsternal thymectomy. Surg Endosc 26(261):266

    Google Scholar 

  4. Regnard J, Magdeleinat P, Dromer C, Dulmet E, De Montpreville V, Levi J et al (1996) Prognostic factors and long-term results after thymoma resection: a series of 307 patients. J Thorac Cardiovasc Surg 112(376):384

    Google Scholar 

  5. Intuitive Surgical—Company—Clinical Evidence Intuitive surgical. Available at http://www.intuitivesurgical.com/company/clinical-evidence/. Accessed 16 April 2016

  6. Yoshino I, Hashizume M, Shimada M, Tomikawa M, Tomiyasu M, Suemitsu R et al (2001) Thoracoscopic thymomectomy with the da Vinci computer-enhanced surgical system. J Thorac Cardiovasc Surg 122(783):785

    Google Scholar 

  7. Ismail M, Swierzy M, Rückert R, Rückert J (2014) Robotic thymectomy for myasthenia gravis. Thorac Surg Clin 24(189):195

    Google Scholar 

  8. Swierzy M, Badakhshi H, Meisel A, Ismail M, Rueckert J (2015) Robotic-assisted thymectomy: surgical procedure and results. Thorac Cardiovasc Surg 63(194):200

    Google Scholar 

  9. Marulli G, Rea F, Melfi F, Schmid T, Ismail M, Fanucchi O et al (2012) Robot-aided thoracoscopic thymectomy for early-stage thymoma: a multicenter European study. J Thorac Cardiovasc Surg 144(1125):1132

    Google Scholar 

  10. Toker A, Sonett J, Zielinski M, Rea F, Tomulescu V, Detterbeck F (2011) Standard terms, definitions, and policies for minimally invasive resection of thymoma. J Thorac Oncol 6(1739):1742

    Google Scholar 

  11. Weissenbacher A, Bodner J (2010) Robotic surgery of the mediastinum. Thorac Surg Clin 20(331):339

    Google Scholar 

  12. Ismail M, Swierzy M, Rückert J (2013) State of the art of robotic thymectomy. World J Surg 37(2740):2746

    Google Scholar 

  13. Rückert J, Ismail M, Swierzy M, Sobel H, Rogalla P, Meisel A et al (2008) Thoracoscopic thymectomy with the da Vinci robotic system for myasthenia gravis. Ann N Y Acad Sci 1132(329):335

    Google Scholar 

  14. Rückert J (2000) Radicality of thoracoscopic thymectomy—an anatomical study. Eur J Cardiothorac Surg 18(735):736

    Google Scholar 

  15. Cerfolio R, Bryant A, Minnich D (2011) Starting a robotic program in general thoracic surgery: why, how, and lessons learned. Ann Thorac Surg 91(1729):1737

    Google Scholar 

  16. Dynamic-page [Internet]. Davincisurgerycommunity.com. 2016 Available at https://www.davincisurgerycommunity.com/d/CL/TH&tab1=CL. Accessed 16 April 2016

  17. Deen S, Farivar A, Louie B (2013) Thoracic techniques: robotic thymectomy for thymoma. Indian J Surg Oncol 4(132):137

    Google Scholar 

  18. Wagner O, Louie B, Vallières E, Aye R, Farivar A (2012) Near-infrared fluorescence imaging can help identify the contralateral phrenic nerve during robotic thymectomy. Ann Thorac Surg 94(622):625

    Google Scholar 

  19. Suda T, Tochii D, Tochii S, Takagi Y (2015) Trans-subxiphoid robotic thymectomy. Interact CardioVasc Thorac Surg 20(669):671

    Google Scholar 

  20. Suda T, Kaneda S, Hachimaru A, Tochii D, Maeda R, Tochii S, Takagi Y (2016) Thymectomy via a subxiphoid approach: single-port and robot-assisted. J Thorac Dis 8(Suppl 3):S265–S271. doi:10.3978/j.issn.2072-1439.2016.02.34

    PubMed  PubMed Central  Google Scholar 

  21. Augustin F, Schmid T, Sieb M, Lucciarini P, Bodner J (2008) Video-assisted thoracoscopic surgery versus robotic-assisted thoracoscopic surgery thymectomy. Ann Thorac Surg 85(768):771

    Google Scholar 

  22. Rückert J, Ismail M, Swierzy M, Sobel H, Rogalla P, Meisel A et al (2008) Thoracoscopic thymectomy with the da Vinci robotic system for myasthenia gravis. Ann N Y Acad Sci 1132(329):335

    Google Scholar 

  23. Ashton R, McGinnis K, Connery C, Swistel D, Ewing D, DeRose J (2003) Totally endoscopic robotic thymectomy for myasthenia gravis. Ann Thorac Surg 75(569):571

    PubMed  Google Scholar 

  24. Savitt M, Gao G, Furnary A, Swanson J, Gately H, Handy J (2005) Application of robotic-assisted techniques to the surgical evaluation and treatment of the anterior mediastinum. Ann Thorac Surg 79(450):455

    Google Scholar 

  25. Rea F, Marulli G, Bortolotti L, Feltracco P, Zuin A, Sartori F (2006) Experience with the “Da Vinci” robotic system for thymectomy in patients with myasthenia gravis: report of 33 cases. Ann Thorac Surg 81(455):459

    Google Scholar 

  26. Goldstein S, Yang S (1080) Assessment of robotic thymectomy using the myasthenia gravis foundation of America guidelines. Ann Thorac Surg 2010(89):1086

    Google Scholar 

  27. Freeman R, Ascioti A, Van Woerkom J, Vyverberg A, Robison R (1018) Long-term follow-up after robotic thymectomy for nonthymomatous myasthenia gravis. Ann Thorac Surg 2011(92):1023

    Google Scholar 

  28. Melfi F, Fanucchi O, Davini F, Viti A, Lucchi M, Ambrogi M et al (2012) Ten-year experience of mediastinal robotic surgery in a single referral centre. Eur J Cardiothorac Surg 41(847):851

    Google Scholar 

  29. Marulli G, Maessen J, Melfi F, Schmid TA, Keijzers M, Fanucchi O, Augustin F, Comacchio GM, Mussi A, Hochstenbag M, Rea F (2016) Multi-institutional European experience of robotic thymectomy for thymoma. Ann Cardiothorac Surg 5(1):18–25. doi:10.3978/j.issn.2225-319X.2015.08.13

    PubMed  PubMed Central  Google Scholar 

  30. Wilshire C, Vallières E, Shultz D, Aye R, Farivar A, Louie B (2016) Robotic resection of 3 cm and larger thymomas is associated with low perioperative morbidity and mortality. Innov Technol Tech Cardiothorac Vasc Surg 11(5):321–326

    Article  Google Scholar 

  31. Kang C, Hwang Y, Lee H, Park I, Kim Y (2016) Robotic thymectomy in anterior mediastinal mass: propensity score matching study with transsternal thymectomy. Ann Thorac Surg 102(3):895–901

    Article  PubMed  Google Scholar 

  32. Friedant AJ, Handorf EA, Su S, Scott WJ (2015) Minimally invasive versus open thymectomy for thymic malignancies: systematic review and meta-analysis. J Thorac Oncol 11(1):30–38

    Article  Google Scholar 

  33. Marulli G, Schiavon M, Perissinotto E, Bugana A, Di Chiara F, Rebusso A et al (2013) Surgical and neurologic outcomes after robotic thymectomy in 100 consecutive patients with myasthenia gravis. J Thorac Cardiovasc Surg 145(730):736

    Google Scholar 

  34. Keijzers M, de Baets M, Hochstenbag M, Abdul-Hamid M, zur Hausen A, van der Linden M et al (2014) Robotic thymectomy in patients with myasthenia gravis: neurological and surgical outcomes. Eur J Cardiothorac Surg 48(40):45

    Google Scholar 

  35. Ye B, Tantai J, Li W, Ge X, Feng J, Cheng M et al (2013) Video-assisted thoracoscopic surgery versus robotic-assisted thoracoscopic surgery in the surgical treatment of Masaoka stage I thymoma. World J Surg Oncol 11:157

    Article  PubMed  PubMed Central  Google Scholar 

  36. Ye B, Li W, Ge X, Feng J, Ji C, Cheng M et al (2013) Surgical treatment of early-stage thymomas: robot-assisted thoracoscopic surgery versus transsternal thymectomy. Surg Endosc 28(122):126

    Google Scholar 

  37. Sivarajah M, Weksler B (2010) Robotic-assisted resection of a thymoma after two previous sternotomies. Ann Thorac Surg 90(668):670

    Google Scholar 

  38. Luzzi L, Corzani R, Burali G, Ciampelli L, Ghisalberti M, Meniconi F, Astaneh A, Baldi M, D’Onofrio P, Ciabatti P (2016) First case of combined robot-assisted thymectomy and transaxillary thyroidectomy: technique and robot-docking optimization. J Robot Surg. doi:10.1007/s11701-016-0632-6

    PubMed  Google Scholar 

  39. Meehan J, Sandler A (2008) Robotic resection of mediastinal masses in children. J Laparoendosc Adv Surg Tech 18(114):119

    Google Scholar 

  40. Hartwich J, Tyagi S, Margaron F, Oitcica C, Teasley J, Lanning D (2012) Robot-assisted thoracoscopic thymectomy for treating myasthenia gravis in children. J Laparoendosc Adv Surg Tech 22(925):929

    Google Scholar 

  41. Pandey R, Garg R, Chandralekha, Darlong V, Punj J, Sinha R et al (2010) Robot-assisted thoracoscopic thymectomy: perianaesthetic concerns. Eur J Anaesthesiol 27(473):477

    Google Scholar 

  42. Campos J, Ueda K (2014) Update on anesthetic complications of robotic thoracic surgery. Minerva Anestesiol 80(83):88

    Google Scholar 

  43. Pandey R, Elakkumanan L, Garg R, Jyoti B, Mukund C, Chandralekha et al (2009) Brachial plexus injury after robotic-assisted thoracoscopic thymectomy. J Cardiothorac Vasc Anest 23:584–586

    Article  Google Scholar 

  44. Balduyck B, Hendriks J, Lauwers P, Mercelis R, Ten Broecke P, Van Schil P (2011) Quality of life after anterior mediastinal mass resection: a prospective study comparing open with robotic-assisted thoracoscopic resection. Eur J Cardiothorac Surg 39(543):548

    Google Scholar 

  45. Ricciardi R, Melfi F, Maestri M, De Rosa A, Petsa A, Lucchi M, Mussi A (2016) Endoscopic thymectomy: a neurologist’s perspective. Ann Cardiothorac Surg 5(1):38–44. doi:10.3978/j.issn.2225-319X.2015.12.02

    PubMed  PubMed Central  Google Scholar 

  46. Kumar A, Asaf B (2015) Robotic thoracic surgery: the state of the art. J Min Access Surg 11:60

    Article  Google Scholar 

  47. Rowse P, Roden A, Corl F, Allen M, Cassivi S, Nichols F et al (2015) Minimally invasive thymectomy: the Mayo Clinic experience. Ann Cardiothorac Surg 4:519–526. doi:10.3978/j.issn.2225-319X.2015.07.03

    PubMed  PubMed Central  Google Scholar 

  48. Jun Y, Hao L, Demin L, Guohua D, Hua J, Yi S (2014) Da Vinci robot-assisted system for thymectomy: experience of 55 patients in China. Int J Med Robot Comput Assist Surg 10(294):299

    Google Scholar 

  49. Seong Y, Kang C, Choi J, Kim H, Jeon J, Park I et al (2013) Early clinical outcomes of robot-assisted surgery for anterior mediastinal mass: its superiority over a conventional sternotomy approach evaluated by propensity score matching. Eur J Cardiothorac Surg 45(68):73

    Google Scholar 

  50. Keijzers M, Dingemans A, Blaauwgeers H, van Suylen R, Hochstenbag M, van Garsse L et al (2013) 8 Years’ experience with robotic thymectomy for thymomas. Surg Endosc 28(1202):1208

    Google Scholar 

  51. Mussi A, Fanucchi O, Davini F, Lucchi M, Picchi A, Ambrogi M et al (2012) Robotic extended thymectomy for early-stage thymomas. Eur J Cardiothorac Surg 41(43):47

    Google Scholar 

  52. Schneiter D, Tomaszek S, Kestenholz P, Hillinger S, Opitz I, Inci I et al (2012) Minimally invasive resection of thymomas with the da Vinci(R) surgical system. Eur J Cardiothorac Surg 43(288):292

    Google Scholar 

  53. Rückert J, Swierzy M, Ismail M (2011) Comparison of robotic and nonrobotic thoracoscopic thymectomy: a cohort study. J Thorac Cardiovasc Surg 141(673):677

    Google Scholar 

  54. Rea F, Schiavon M, Di Chiara F, Marulli G (2011) Single-institution experience on robot-assisted thoracoscopic operations for mediastinal diseases. Innov Technol Tech Cardiothorac Vasc Surg 6(5):316–322

    Article  Google Scholar 

  55. Fleck T, Fleck M, Muller M, Hager H, Klepetko W, Wolner E et al (2009) Extended videoscopic robotic thymectomy with the da Vinci telemanipulator for the treatment of myasthenia gravis: the Vienna experience. Interact Cardiovasc Thorac Surg 9(784):787

    Google Scholar 

  56. Tomulescu V (2009) First year experience of robotic-assisted laparoscopic surgery with 153 cases in a General Surgery Department: indications, technique and results. Chirurgia 2:141–150

    Google Scholar 

  57. Braumann C, Jacobi C, Menenakos C, Ismail M, Rueckert J, Mueller J (2008) Robotic-assisted laparoscopic and thoracoscopic surgery with the da Vinci system. Surg Laparosc Endosc Percutaneous Tech 18(260):266

    Google Scholar 

  58. Castle S, Kernstine K (2008) Robotic-assisted thymectomy. Semin Thorac Cardiovasc Surg 20(326):331

    Google Scholar 

Download references

Acknowledgements

The author would like to thank Dr Joel C. Nwaubani for his support in this project.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Antonia Gkouma.

Ethics declarations

Conflict of interest

Antonia Gkouma declares that she has no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gkouma, A. Robotically assisted thymectomy: a review of the literature. J Robotic Surg 12, 3–10 (2018). https://doi.org/10.1007/s11701-017-0748-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-017-0748-3

Keywords

Navigation