Abstract
Robotic Lobectomy has been evolving over the past decade and is an oncologically efficacious procedure. Although robotic lobectomy is performed more frequently around the world, it accounts for a small percentage of all lobectomies. The major determinants for the lower level of adoption of the robotic lobectomy procedure are 1. The lack of concise step by step procedure outlines for the surgeons who are transitioning from either open or video-assisted thoracic surgical procedures to robotics, or 2. A strategy for control of catastrophic bleeding during the robotic lobectomy procedure. The Technique of Robotic Lobectomy Part I outlines a stepwise approach to robotic lobectomy for the right upper, middle, and lower lobes. Part II outlines a stepwise approach to robotic lobectomy for left upper, and lower lobes. Part III outlines a methodical technical approach for the control of catastrophic bleeding complications.
Highlights
The most common indication for lung resection is lung cancer
228,150 (116,440 in men and 111,710 in women) new cases of lung cancer were diagnosed in the United States in 2018
142,670 patients died from lung cancer (76,650 in men and 66,020 in women)[1] Lung cancer is by far the leading cause of cancer death among both men and women
Summary
The most common indication for lung resection is lung cancer. Approximately 228,150 (116,440 in men and 111,710 in women) new cases of lung cancer were diagnosed in the United States in 2018. The most posterior arm is used to retract the upper lobe inferiorly during dissection of stations 2R and 4R, clearing the space between the superior vena cava (SVC) anteriorly, the trachea posteriorly, and the azygos vein inferiorly [Figure 5]. The upper lobe vein is divided using a vascular stapler either using the robot arm or passed through the Figure 7. The dissection begins like that of upper lobectomy by dividing the inferior pulmonary vein and removing station #9, #8, and #7 nodes. The most posterior arm is used to retract the upper lobe inferiorly during dissection of stations 2R and 4R, clearing the space between the SVC anteriorly, the trachea posteriorly, and the azygos vein inferiorly.
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