Robotic sleeve resection for pulmonary disease

Chengqiang Li,Jie Xiang,Bin Zhou,Yu Han,Runsen Jin,Hecheng Li

doi:10.1186/s12957-018-1374-x

Abstract

BackgroundFew studies have described robotic sleeve resection with pulmonary resection. Here, we report the successful implementation of a completely portal robotic sleeve resection with or without pulmonary resection using a modified suture mode.MethodsIn total, 339 patients underwent curative robotic pulmonary surgery at Ruijin Hospital between May 2015 and September 2017. Three of these patients underwent robotic sleeve resection (right upper lobe, one; left upper lobe, one; and lingular segmental bronchus, one). Five port incisions were utilized, and a simple continuous running suture combined with two interrupted sutures of the membranous and cartilaginous junction portion was preferred for the anastomosis.ResultsThe postoperative course was uneventful for two patients with squamous cell carcinoma. The lingular segmental bronchus patient without pulmonary resection (a salivary gland tumor) underwent short-term atelectasis. The median operation time was 155 (range 132–230) minutes. The median anastomosis time was 25 (range 23–32) minutes. The median length of postoperative hospital stay was 7 (range 6–10) days. There was no mortality or conversion to thoracotomy for any of the patients. All patients were followed for 3–6 months, and there is no tumour recurrence.ConclusionsOur limited experience suggested that robotic sleeve resection for pulmonary disease with or without pulmonary resection may be safe and effective. The anastomosis time can be shortened with more robotic surgery experiences and the modified suture mode.

Highlights

The first published bronchial sleeve resection was performed in 1947 [1]
Sleeve resection is a better choice than pneumonectomy when operating on central lung cancer and low-grade neoplasms because of its advantages in terms of improved morbidity, mortality, and lung function preservation [2,3,4,5,6,7], even after induction therapy [8,9,10,11]
The first study describing video-assisted thoracoscopic (VATS) sleeve lobectomy was reported in 2002 [13]; after more than 10 years, there have been only a small number of case series reports [14,15,16,17,18], the morbidity, mortality, and survival were comparable between VATS sleeve lobectomy and thoracotomy

Summary

Introduction

The first published bronchial sleeve resection was performed in 1947 [1]. The key part of sleeve resection is reconstruction, and this remains challenging even during thoracotomy. Like the other thoracic surgeries, sleeve resection has continuously evolved in the era of video-assisted thoracoscopic surgery [12]; due to its technical difficulty, this procedure has been adopted slowly. Surgical robotics might represent a viable solution to this technically complex procedure. Few studies have described robotic sleeve resection with pulmonary resection. We report the successful implementation of a completely portal robotic sleeve resection with or without pulmonary resection using a modified suture mode

Methods

Results

Conclusion