Segmentectomies Made Easy series: robotic-assisted left S1 and S2 segmentectomy.

Area of Science:

• Thoracic Surgery
• Robotic Surgery
• Medical Imaging

Background:

• Robotic-assisted thoracic surgery offers advantages over open thoracotomy, including fewer complications and faster recovery.
• Sublobar resections, such as segmentectomies, are complex and technically demanding, especially for multiple segments.
• Three-dimensional (3D) reconstruction imaging aids pre-operative planning for bronchovascular anatomy in thoracic procedures.

Purpose of the Study:

• To showcase a robotic left S1 and S2 segmentectomy for a primary pulmonary lesion.
• To demonstrate the utility of 3D virtual modeling in planning and executing complex robotic thoracic surgery.
• To provide a step-by-step tutorial on robotic segmentectomy, emphasizing the role of 3D visualization.

Main Methods:

• A robotic left S1 and S2 segmentectomy was performed for a primary pulmonary lesion.
• Pre-operative 3D imaging was utilized to identify anatomical variations and guide surgical planning.
• The procedure involved detailed anatomical delineation, vascular division, and port placement, all visualized in 3D.

Main Results:

• 3D imaging identified key anatomical variances, informing the surgical approach for the left S1 and S2 segmentectomy.
• The robotic platform provided enhanced instrument control and tremor-free tissue handling during the complex resection.
• The tutorial highlights how 3D visualization improved surgical precision and intra-operative decision-making.

Conclusions:

• Robotic-assisted thoracic surgery with 3D guidance is a leading technique for complex pulmonary resections.
• Pre-operative 3D imaging and virtual modeling are crucial for tailored planning and precise execution of segmentectomies.
• This approach optimizes outcomes in robotic-assisted thoracic surgery, despite limited current literature on consistent 3D virtual modeling use.