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Robot-assisted thoracic surgery for complex procedures.

Shuenn-Wen Kuo¹, Pei-Ming Huang¹, Mong-Wei Lin¹

¹Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Journal of Thoracic Disease

|December 10, 2017

Summary

This summary is machine-generated.

Robot-assisted thoracic surgery (RATS) is feasible for complex procedures like large tumor removal. However, difficult dissections require careful attention and preparation for potential conversion to open surgery.

Keywords:

Thoracic surgery robot-assisted surgery

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Area of Science:

Thoracic Surgery
Minimally Invasive Surgery
Robotic Surgery

Background:

Robot-assisted thoracic surgery (RATS) shows outcomes comparable to video-assisted thoracic surgery (VATS).
The efficacy of RATS in complex thoracic procedures, typically requiring open surgery, remains unclear.
This study investigates the preliminary results of RATS in complex thoracic operations.

Purpose of the Study:

To evaluate the feasibility and outcomes of robot-assisted thoracic surgery (RATS) in complex thoracic procedures.
To compare RATS with traditional open surgery for challenging cases.
To identify specific complex procedures where RATS may offer advantages or require modifications.

Main Methods:

Retrospective review of a prospectively collected surgical database (February 2012 - August 2014).
Definition of complex RATS: procedures involving difficult dissections, complex sutures, or excision of large tumors (>8 cm).
Analysis of patient characteristics and perioperative outcomes for complex RATS cases.

Main Results:

30 out of 120 RATS patients underwent complex procedures (21 lung tumors, 9 mediastinal tumors).
Indications included difficult dissections (21), complex sutures (10), and large tumors (7).
Three conversions to thoracotomy occurred due to bleeding; one mortality from sepsis and pulmonary hypertension post-pneumonectomy. Difficult dissections correlated with longer operative time, hospital stay, bleeding, and morbidity.

Conclusions:

Robot-assisted thoracic surgery (RATS) is feasible for complex thoracic procedures, particularly for intricate suturing and large mediastinal tumor excision.
Difficult dissections in complex RATS necessitate increased vigilance and preparedness for conversion to thoracotomy.
Advanced planning for potential intraoperative conversion is crucial for managing complex RATS cases.