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Effective division of the intersegmental plane using a robotic stapler in robotic pulmonary segmentectomy
Mikio Okazaki1, Ken Suzawa2, Kazuhiko Shien2
1Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. mikiookazaki@okayama-u.ac.jp.
Surgery Today
|April 18, 2024
Summary
Robot-assisted thoracoscopic segmentectomy using a robotic stapler safely and effectively divides the intersegmental plane. This approach demonstrated reduced operative time, blood loss, and complications compared to traditional methods.
Area of Science:
- Thoracic surgery
- Minimally invasive surgery
- Surgical oncology
Background:
- Robot-assisted thoracoscopic surgery (RATS) is increasingly used for segmentectomy.
- Precise intersegmental plane division is crucial for oncologic outcomes and lung function preservation.
Purpose of the Study:
- To present a strategy for accurate intersegmental plane division using a robotic stapler in RATS segmentectomy.
- To review the surgical outcomes of this technique.
Main Methods:
- RATS portal segmentectomy performed using the Da Vinci Xi system with robotic stapler dissection.
- Perioperative outcomes evaluated in 92 patients (May 2020-Jan 2023).
- Comparison with 82 patients undergoing complete video-assisted thoracoscopic surgery (CVATS).
Main Results:
- RATS group showed significantly lower operative time, blood loss, postoperative complications, and incision size compared to CVATS.
- No intraoperative complications in RATS; 4.3% postoperative complications.
- RATS required a higher number of staplers than CVATS.
Conclusions:
- Division of the intersegmental plane with a robotic stapler in RATS portal segmentectomy is safe and effective.
- This technique offers advantages in perioperative outcomes over CVATS.
