Abstract
Robotic thoracoscopic surgical operations are increasingly performed worldwide. Current lung resection trends indicate that the robotic approach has now surpassed conventional VATS (video assisted thoracoscopy surgery) in the United States. Emergency conversion to an open thoracotomy is an uncommon occurrence; however, preparedness for this infrequent but potentially catastrophic event is paramount. There is a paucity of step-by-step instruction available on how to convert from robotic thoracoscopy safely and reliably to thoracotomy. Herein, we present our conversion method which has been refined in an iterative fashion based on real-life experience and testing in a simulated environment. This method ensures pressure control of bleeding either by the surgeon or bedside assist while also maintaining vision of the operative field throughout the conversion process. At no point is bleeding control maintained by an unmanned robotic instrument. This technical report aims to provide thoracic surgery teams a safe and reliable option for emergency conversion during robotic thoracoscopy.
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