Initial results of robot-assisted thoracoscopic surgery in Japan.

Abstract

As surgical robots have become increasingly used, verification of their usefulness in the general thoracic surgery field is required. Initial results of robot-assisted thoracoscopic surgery in Japan were investigated. A questionnaire survey was performed to retrospectively examine the current status of robotic surgery for general thoracic disease in Japan. The subjects were 112 cases performed by the end of September 2012 at 9 institutions. There were 60 cases of primary lung cancer, 38 cases of anterior-middle mediastinal disease, and 14 cases of posterior mediastinal disease. In lung cancer cases, the operative time was 284.7min, the blood loss was 129mL, the drainage period was 3.3days, and the conversion rate was 3.3%. The incidence of postoperative complications was 6.7%. The postoperative hospital stay was 8.2days. In cases of anterior-middle mediastinal disease, the operative time was 184.3min, the blood loss was 43.8mL, the drainage period was 2.3days, and there was no conversion. The incidence of postoperative complications was 7.9%. The postoperative hospital stay was 7.1days. In cases of posterior mediastinal disease, the operative time was 142.6min, the blood loss was 61.4mL, the drainage period was 1.6days, and there was no conversion. No postoperative complication developed in any case. The postoperative hospital stay was 5days. In all cases underwent robotic surgery, there was no operation related mortality. Robotic surgery was safely introduced, and the incidence of postoperative complications tended to be low, although the operative time was long. Preparations for its employment in advanced medical care and coverage by national health insurance are urgent issue.