Application of pelvic-style docking in robotic surgery for lower-middle mediastinal tumors

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Robotics

Background:

• Robotic surgery requires specific port and robot positioning for optimal visualization and instrument manipulation.
• Tumors located below the inferior pulmonary vein present unique challenges in standard robotic thoracic procedures.
• Conventional port placements may lead to suboptimal angles and potential robotic arm collisions in lower mediastinal cases.

Purpose of the Study:

• To describe an alternative approach for robotic surgery in patients with lower middle mediastinal tumors.
• To evaluate the feasibility and effectiveness of using the "Pelvic" setting for robotic access to the lower mediastinum.
• To address challenges related to port placement and robotic arm interference in specific thoracic tumor locations.

Main Methods:

• Retrospective analysis of 4 patients with lower middle mediastinal tumors undergoing robotic surgery.
• Utilized the "Pelvic" setting on the patient cart's visual pad for port placement and robot docking.
• Assessed the ease of manipulation and incidence of robotic arm collisions.

Main Results:

• The "Pelvic" setting facilitated improved access for lower middle mediastinal tumor manipulation.
• This approach resulted in minimal issues with robotic arm collisions.
• Successful robotic procedures were completed in all 4 analyzed cases.

Conclusions:

• The "Pelvic" setting is a viable and effective modification for robotic-assisted thoracic surgery involving lower middle mediastinal tumors.
• This technique enhances surgical access and mitigates common robotic arm collision problems.
• Further investigation into this approach may optimize outcomes for challenging mediastinal tumor resections.