Related Experiment Video
Updated: May 15, 2025
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report
Ghada Shahin1, Rohit Kharbanda2, Quirijn Tummers3
1Department of Cardiothoracic Surgery, Leiden University Medical Center, Subspecialty Thoracic Surgery, Albinusdreef 2, Leiden, ZA, 2333, the Netherlands. g.m.m.shahin@lumc.nl.
Background:
Robot-assisted Thoracic Surgery (RATS) is well-established for complex minimally invasive thoracic surgery. Despite the available literature, robotics for complex advanced NSCLC for re-do surgery remains underexplored.
Case Presentation:
We present a 55-year-old female who underwent esophagectomy with gastric pull-up reconstruction for squamous cell carcinoma (SCC) of the esophagus (cT3N2M0, stage IIIB) after neo-adjuvant concurrent chemoradiation therapy (ypT2N1 stage IIB disease). Six years later, computed tomography (CT) scan showed stage IA Thyroid Transcription Factor-1 (TTF-1) positive adenocarcinoma in the left upper lobe treated by stereotactic radiotherapy. Two years later, a SCC of the right upper lobe (RUL) was found (Fig. 1). Although locoregional therapy was preferred Pembrolizumab® was initiated with curative intent as the tumor demonstrated a high Programmed Death-Ligand 1 (PD-L1) expression. Follow-up CT-scan showed no biological response. Salvage lobectomy was proposed, and patient consent obtained. As demonstrated in the video, RATS provided great exposure to the adhesions, vascularization of the neo-oesophagus and maximal dexterity in difficult spaces.
Conclusions:
This case demonstrates the value of RATS in complex re-do thoracic surgery after immunotherapy and previous thoracotomy.
