Segmentectomies Made Easy series: robotic-assisted left S3 segmentectomy

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Medical Imaging

Background:

• Robotic-assisted thoracic surgery provides enhanced visualization and precision for complex pulmonary resections.
• While beneficial, robotic sublobar resections like segmentectomies present technical challenges, especially with anatomical variations.
• 3D reconstruction imaging aids in pre-operative assessment and surgical planning for improved accuracy.

Purpose of the Study:

• To demonstrate a robotic left S3 segmentectomy for a metastatic pulmonary lesion.
• To highlight the role of pre-operative 3D imaging in managing anatomical variants during robotic segmentectomy.
• To provide a structured tutorial on robotic segmentectomy, emphasizing 3D visualization's impact on accuracy and outcomes.

Main Methods:

• A robotic left S3 segmentectomy was performed for a metastatic pulmonary lesion.
• Pre-operative 3D imaging was utilized to identify and plan for distinct bronchovascular anatomical variants.
• The surgical procedure was documented step-by-step, from port placement to segmental resection and anatomical identification.

Main Results:

• Robotic-assisted surgery facilitated precise dissection and resection despite anatomical complexities.
• Pre-operative 3D imaging was crucial in adapting the surgical strategy to identified anatomical variants.
• The case illustrates the potential of 3D visualization to enhance intra-operative decision-making in robotic segmentectomy.

Conclusions:

• Robotic segmentectomy, guided by 3D imaging, can effectively manage complex pulmonary resections with anatomical variations.
• The integration of 3D virtual modeling in robotic thoracic surgery requires further investigation and wider adoption.
• This tutorial emphasizes the value of 3D visualization in optimizing outcomes for robotic segmentectomies.