Robotic tracheal resection and reconstruction for tracheobronchial mucoepidermoid carcinoma

Tracheobronchial mucoepidermoid carcinoma is a rare malignancy characterized by indolent growth and often delayed clinical presentation. While surgical resection remains the definitive treatment with excellent long-term outcomes, the surgical approach continues to evolve. While traditional techniques include thoracotomy or sternotomy, robotic-assisted surgery is emerging as a compelling alternative, offering enhanced three-dimensional visualization, superior instrument precision, and improved ergonomic control for complex airway reconstructions. This video tutorial details a robotic approach for the resection of residual tracheal mucoepidermoid carcinoma following initial debulking. We highlight the technical nuances required to transition from conventional methods to a robotic platform. The procedure is performed using a four-arm robotic configuration supplemented by a single assistant port. Airway management is maintained via single-lung ventilation using a specialized "North Pole" endotracheal tube. The video illustrates the systematic dissection of the trachea, precise margin control, and the intraoperative manoeuvres utilized to ensure a tension-free anastomosis with the endotracheal tube in situ.