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A community hospital’s experience with robotic thoracic surgery

Indian Journal of Thoracic and Cardiovascular Surgery volume 36, pages 142–147 (2020)Cite this article

Abstract

Introduction

The emergence of minimally invasive thoracic surgery has positively impacted postoperative recovery. Robotic-assisted thoracoscopic surgery (RATS) has been shown to have equivalent short- and long-term outcomes as compared with video-assisted thoracoscopic surgery (VATS). The introduction of RATS offers a three-dimensional high-definition image, improved ergonomics, and wristed movement. The purpose of this paper was to define the learning curve of RATS.

Methods

This study is a retrospective review of a single surgeon’s RATS experience in a community hospital. All patients who underwent RATS between December 2011 and April 2014 were included. The cohort was divided into 2 groups: “early” and “late.” These groups were created based on the date before or after February 2013, respectively. Data is presented as means and percentages. Significance was defined as a P value < 0.05. All categorical variables were evaluated with Fisher’s exact t test and all continuous variables were compared via a paired t test.

Results

Seventy-nine patients were identified with a mean age of 59. There were 39 patients in the early group and 40 in the late. Rates of conversion to open thoracotomy (13% vs 10%, P = 0.74) and operative time (180 vs 204 min, P = 0.34) did not demonstrate any statistical significance between the two cohorts. Postoperative morbidity (21% vs 28%, P = 0.60) and mortality (3% vs 0%, P = 1.00) were equivalent between both groups. There was a higher percentage of lobectomies performed during the late group (38% vs 65%, P = 0.02). Furthermore, these lobectomies were performed at a faster rate in the late group.

Conclusion

Based on our experience, the complexity of the operations that can be performed robotically increased with the number of operations performed without an impact on postoperative morbidity and mortality.

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Authors and Affiliations

  1. Department of Internal Medicine, Drexel University College of Medicine/Hahnemann University Hospital, 245 North Broad Street MS 427, Philadelphia, PA, 19102, USA

    Nihaal Karnik

  2. United States Public Health Service, Rockville, MD, USA

    Xihua Yang

  3. Division of Transplant Surgery, University of Maryland Medical Center, Baltimore, MD, USA

    Naeem Goussous

  4. Division of General Surgery, Kendall Regional Medical Center, Miami, FL, USA

    Lindsay Howe

  5. Department of Thoracic Surgery, St. Agnes Hospital, Baltimore, MD, USA

    Riny Karras

Authors
  1. Nihaal Karnik
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  2. Xihua Yang
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  3. Naeem Goussous
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  4. Lindsay Howe
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  5. Riny Karras
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Correspondence to Nihaal Karnik.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. It should be noted that this was a retrospective study and the study design, review, and analysis was in compliance with our institution’s ethical standards for retrospective studies.

Human and animal rights and informed consent

This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study. No identifying information is present in the presented work.

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Presented as a poster in the 52nd Annual Meeting of the Eastern Cardiothoracic Surgical Society (ECTSS), Palm Beach, FL, October 10, 2014

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Cite this article

Karnik, N., Yang, X., Goussous, N. et al. A community hospital’s experience with robotic thoracic surgery. Indian J Thorac Cardiovasc Surg 36, 142–147 (2020). https://doi.org/10.1007/s12055-019-00848-5

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  • DOI: https://doi.org/10.1007/s12055-019-00848-5

Keywords

  • Robotic thoracic surgery
  • Learning curve
  • Lobectomy