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Emergency rollout and conversion procedures during the three-arm robotic open-thoracotomy-view approach
Noriaki Sakakura1, Takeo Nakada1, Suguru Shirai1
1Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Interactive Cardiovascular and Thoracic Surgery
|December 1, 2021
Summary
The robotic open-thoracotomy-view approach (OTVA) offers a viable option for robotic lung resections (RLRs). This method demonstrated a low conversion rate to video-assisted thoracoscopic surgery (VATS), with no conversions to open thoracotomy.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robotic lung resections (RLRs) aim to replicate open-thoracotomy surgery (OTS) views.
- The robotic open-thoracotomy-view approach (OTVA) utilizes vertical port placement and confronting monitors.
Purpose of the Study:
- To evaluate the feasibility and safety of the OTVA for RLRs.
- To describe procedures for emergency rollout and conversion from OTVA to OTS or VATS.
Main Methods:
- Retrospective review of 88 patients undergoing RLR with three-arm OTVA (da Vinci Xi).
- Vertical axillary port placement with confronting monitors and assistants.
- Prepared conversion strategies: emergency thoracotomy, cool vertical thoracotomy, and VATS conversion.
Main Results:
- No emergent or cool conversions to open thoracotomy occurred.
- Two patients (2.3%) required conversion to confronting VATS.
- Conversions were due to hemorrhage and stapling difficulties; all patients had uneventful postoperative courses.
Conclusions:
- The OTVA setting is a feasible option for robotic lung resections.
- The described emergent rollout and conversion procedures support its clinical application.
