Abstract
An incomplete interlobar fissure makes thoracoscopic lobectomy difficult and is predictive of morbidity after thoracoscopic lobectomy. This report demonstrates the robot-assisted thoracoscopic (RATS) lobectomy technique for patients with severe incomplete interlobar fissures. A fissureless approach was chosen for pulmonary resection. Near-infrared fluorescence imaging with intravenous indocyanine green (ICG) was used to detect the interlobar line after transection of the bronchus, pulmonary artery and vein. Interlobar fissure was identified and divided by robotic staplers. This combined technique using ICG and fissureless lobectomy made RATS lobectomy safe for patients with severe incomplete interlobar fissures.
Highlights
Incomplete interlobar fissures increase the surgical difficulty of video-assisted thoracoscopic surgery (VATS) lobectomy
Interlobar fissure was identified and divided by robotic staplers. This combined technique using indocyanine green (ICG) and fissureless lobectomy made robot-assisted thoracoscopic (RATS) lobectomy safe for patients with severe incomplete interlobar fissures
This study demonstrates a useful RATS lobectomy technique in patients with severe incomplete interlobar fissures
Summary
Incomplete interlobar fissures increase the surgical difficulty of video-assisted thoracoscopic surgery (VATS) lobectomy. An incomplete interlobar fissure makes thoracoscopic lobectomy difficult and is predictive of morbidity after thoracoscopic lobectomy. This report demonstrates the robot-assisted thoracoscopic (RATS) lobectomy technique for patients with severe incomplete interlobar fissures. A fissureless approach was chosen for pulmonary resection.
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