Robot-Assisted Lobectomy With Venoarterial Extracorporeal Membrane Oxygenation Support

Intraoperative extracorporeal membrane oxygenation (ECMO) support during thoracic surgery for high-risk patients has most commonly been performed and reported in open cases. Minimally invasive thoracic surgery with venoarterial (VA) ECMO support has not been reported before. We report a successful case of VA ECMO-assisted robotic right upper lobectomy in a hemodynamically labile patient with severe bullous emphysema, hypoxia-induced severe pulmonary hypertension, and cor pulmonale. In select patients at increased risk for cardiopulmonary instability, VA ECMO can facilitate safe conduct of minimally invasive thoracic operations.