Abstract
Increasingly, minimally invasive video-assisted thoracic surgery (VATS) is being utilized for pulmonary resection because of patient benefits over traditional thoracotomy, such as decreased length of stay, decreased short-term postoperative pain, and fewer complications. VATS lobectomy, initially described in multiple series in 1993, has proven to be feasible and oncologically acceptable for surgical eradication of non-small cell lung cancer (NSCLC) and other isolated tumors and conditions. However, despite multiple studies demonstrating these advantages, VATS for anatomic resection is still not the standard approach and is only slowly being implemented more widely. The explanation is likely multifactorial including (1) technical issues, such as two-dimensional imaging and limited maneuverability of instrumentation; (2) lack of adequate training; and (3) concerns about the consequences of major vascular injury with a closed chest approach. Telerobotic technology addresses some of these barriers and is being increasingly utilized during minimally invasive pulmonary resection. This chapter will review the technical aspects of robotic lung resection and some of the challenges for future utilization of this costly technology.
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Incision strategy and docking. This video demonstrates the incision strategy for a 3-arm robotic lobectomy with a VATS-based approach with use of a utility incision. Subsequently, the docking procedure is shown (MOV 182522 kb)
Right upper lobe robotic lobectomy. A robotic RUL lobectomy is demonstrated reviewing the steps required for an anterior to posterior approach (MOV 220569 kb)
Right lower lobe robotic lobectomy. The steps of a robotic lower lobectomy are demonstrated. A right sided procedure is shown and is analogous to a left lower lobectomy as well (MOV 1008279 kb)
Left upper lobe robotic lobectomy. An anterior to posterior LUL robotic lobectomy is reviewed (MOV 348009 kb)
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Park, B.J., Glanville, J., Baranski, G. (2015). Essentials and Future Directions of Robotic Major Pulmonary Resection. In: Kroh, M., Chalikonda, S. (eds) Essentials of Robotic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-09564-6_12
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DOI: https://doi.org/10.1007/978-3-319-09564-6_12
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