Clinical Analysis of 12 Patients Undergoing Robot-assisted Pulmonary Lobectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LUOQing-quan ¹ , LINHao ¹ , HUANGJia ¹ ,  XULin ²

1. Shanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai 200030, P. R. China;
2. Department of Thoracic Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing 210009, P. R. China;

Corresponding author：

XULin, Email: xulin83@vip.sina.com

Keywords：

Robotic surgery; Pulmonary lobectomy; Minimally invasive thoracic surgery; Lung cancer

DOI：

10.7507/1007-4848.20140008

Video：

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Objective To investigate the safety and efficacy of robot-assisted pulmonary lobectomy using da Vinci S System, and explore its advantages in minimally invasive surgery. Methods From May 2009 to May 2013, 12 patients with suspected non-small cell lung cancer (NSCLC) underwent robot-assisted lobectomy using da Vinci S System in Shanghai Chest Hospital. There were 6 male and 6 female patients with their age of 40-61 (52±8) years. Robotic instruments were used through a 12-mm observation port, two 8-mm thoracoscopic ports and a 12 to 40 mm utility incision without rib spreading. Perioperative data of the patients were collected and analyzed. Results All the 12 patients successfully received surgical resection. All types of lobectomy were performed, and all the procedures were radical resection. Each patient received 4 to 9 (5±1) stations of lymph node dissection. None of the patients underwent conversion to thoracotomy. There was no perioperative mortality or morbidity in this group. Chest drainage duration was 3-11 (8±7) days. Length of hospital stay was 6 to 18 (14±8) days. Operation time was 60 to 280 (185±78) minutes. Intraoperative blood loss was 20 to 200 (108±71) ml. There was no perioperative blood transfusion. Conclusions Robot-assisted lobectomy is initially proven a safe and effective procedure with enhanced visualization and better dexterity and stability than video-assisted thoracopscopic surgery. Thus surgical indications for robot-assisted lobectomy can be widened. Robot-assisted lobectomy is an important choice in the new age of minimally invasive thoracic surgery.

Citation： LUOQing-quan, LINHao, HUANGJia, XULin. Clinical Analysis of 12 Patients Undergoing Robot-assisted Pulmonary Lobectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(1): 25-28. doi: 10.7507/1007-4848.20140008 Copy

1.	Nagahiro I, Andou A, Aoe M, et al.Pulmonary function, postoperative pain, and serum cytokine level after lobectomy:a comparison of VATS and conventional procedure.Ann Thorac Surg, 2001, 72 (2):362-365.
2.	Förster R, Storck M, Schäfer JR, et al.Thoracoscopy versus thoracotomy:a prospective comparison of trauma and quality of life. Langenbecks Arch Surg, 2002, 387 (1):32-36.
3.	Dieter RA Jr, Kuzycz GB.Complications and contraindications of thoracoscopy.Int Surg, 1997, 82 (3):232-239.
4.	黄佳, 罗清泉, 谭强.机器人外科手术系统辅助胸腔镜胸腺瘤切除手术一例.上海医学, 2010, 33 (11):1072.
5.	National Comprehensive Cancer Network.Distress Management.v.3, NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines).2012:41-45.
6.	Thomas P, Doddoli C, Yena S, et al.VATS is an adequate oncological operation for stage I non-small cell lung cancer.Eur J.Cardiothorac Surg, 2002, 21 (6):1094-1099.
7.	Cakar F, Werner P, Augustin F, et al.A comparison of outcomes after robotic open extended thymectomy for myasthenia gravis.Eur J Cardiothorac Surg, 2007, 31 (3):501-505.
8.	Boffa DJ, Allen MS, Grab JD, et al.Data from The Society of Thoracic Surgeons General Thoracic Surgery database:the surgical management of primary lung tumors.J Thorac Cardiovasc Surg, 2008, 135 (2):247-254.
9.	Gopaldas RR, Bakeen FG, Dao TK, et al.Video-assisted thoracoscopic versus open thoracotomy lobectomy in a cohort of 13, 619 patients.Ann Thorac Surg, 2010, 89 (5):1563-1570.
10.	Augustin F, Bodner J, Wykypiel H, et al.Initial experience with robotic lung lobectomy:report of two different approaches.Surg Endosc, 2011, 25 (1):108-113.
11.	Veronesi G, Galetta D, Maisonneuve P, et al.Four-arm robotic lobectomy for the treatment of early-stage lung cancer.J Thorac Cardiovasc Surg, 2010, 140 (1):19-25.
12.	Park BJ, Flores RM, Rusch VW.Robotic assistance for videoassisted thoracic surgical lobectomy:technique and initial results.J Thorac Cardiovasc Surg, 2006, 131 (1):54-59.
13.	Meyer M, Gharagozloo F, Tempesta B, et al.The learning curve of robotic lobectomy.Int J Med Robot, 2012, 8 (4):448-452.
14.	Park BJ, Melfi F, Mussi A, et al.Robotic lobectomy for non-small cell lung cancer (NSCLC):long-term oncologic results.J Thorac Cardiovasc Surg, 2012, 143 (2):383-389.
15.	McKenna RJ Jr, Houck W, Fuller CB.Video-assisted thoracic surgery lobectomy:experience with 1, 100 cases.Ann Thorac Surg, 2006, 81 (2):421-426.
16.	Onaitis MW, Petersen RP, Balderson SS, et al.Thoracoscopic lobectomy is a safe and versatile procedure.Ann Surg, 2006, 244 (3):420-425.
17.	Flores RM, Park BJ, Dycoco J, et al.Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer.J Thorac Cardiovasc Surg, 2009, 138 (1):11-18.
18.	Kaul S, Shah NL, Menon M.Learning curve using robotic surgery.Curr Urol Rep, 2006, 7 (2):125-129.
19.	Lanfranco AR, Castellanos AE, Desai JP, et al.Robotic surgery:a current perspective.Ann Surg, 2004, 239 (1):14-21.

1. Nagahiro I, Andou A, Aoe M, et al.Pulmonary function, postoperative pain, and serum cytokine level after lobectomy:a comparison of VATS and conventional procedure.Ann Thorac Surg, 2001, 72 (2):362-365.
2. Förster R, Storck M, Schäfer JR, et al.Thoracoscopy versus thoracotomy:a prospective comparison of trauma and quality of life. Langenbecks Arch Surg, 2002, 387 (1):32-36.
3. Dieter RA Jr, Kuzycz GB.Complications and contraindications of thoracoscopy.Int Surg, 1997, 82 (3):232-239.
4. 黄佳, 罗清泉, 谭强.机器人外科手术系统辅助胸腔镜胸腺瘤切除手术一例.上海医学, 2010, 33 (11):1072.
5. National Comprehensive Cancer Network.Distress Management.v.3, NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines).2012:41-45.
6. Thomas P, Doddoli C, Yena S, et al.VATS is an adequate oncological operation for stage I non-small cell lung cancer.Eur J.Cardiothorac Surg, 2002, 21 (6):1094-1099.
7. Cakar F, Werner P, Augustin F, et al.A comparison of outcomes after robotic open extended thymectomy for myasthenia gravis.Eur J Cardiothorac Surg, 2007, 31 (3):501-505.
8. Boffa DJ, Allen MS, Grab JD, et al.Data from The Society of Thoracic Surgeons General Thoracic Surgery database:the surgical management of primary lung tumors.J Thorac Cardiovasc Surg, 2008, 135 (2):247-254.
9. Gopaldas RR, Bakeen FG, Dao TK, et al.Video-assisted thoracoscopic versus open thoracotomy lobectomy in a cohort of 13, 619 patients.Ann Thorac Surg, 2010, 89 (5):1563-1570.
10. Augustin F, Bodner J, Wykypiel H, et al.Initial experience with robotic lung lobectomy:report of two different approaches.Surg Endosc, 2011, 25 (1):108-113.
11. Veronesi G, Galetta D, Maisonneuve P, et al.Four-arm robotic lobectomy for the treatment of early-stage lung cancer.J Thorac Cardiovasc Surg, 2010, 140 (1):19-25.
12. Park BJ, Flores RM, Rusch VW.Robotic assistance for videoassisted thoracic surgical lobectomy:technique and initial results.J Thorac Cardiovasc Surg, 2006, 131 (1):54-59.
13. Meyer M, Gharagozloo F, Tempesta B, et al.The learning curve of robotic lobectomy.Int J Med Robot, 2012, 8 (4):448-452.
14. Park BJ, Melfi F, Mussi A, et al.Robotic lobectomy for non-small cell lung cancer (NSCLC):long-term oncologic results.J Thorac Cardiovasc Surg, 2012, 143 (2):383-389.
15. McKenna RJ Jr, Houck W, Fuller CB.Video-assisted thoracic surgery lobectomy:experience with 1, 100 cases.Ann Thorac Surg, 2006, 81 (2):421-426.
16. Onaitis MW, Petersen RP, Balderson SS, et al.Thoracoscopic lobectomy is a safe and versatile procedure.Ann Surg, 2006, 244 (3):420-425.
17. Flores RM, Park BJ, Dycoco J, et al.Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer.J Thorac Cardiovasc Surg, 2009, 138 (1):11-18.
18. Kaul S, Shah NL, Menon M.Learning curve using robotic surgery.Curr Urol Rep, 2006, 7 (2):125-129.
19. Lanfranco AR, Castellanos AE, Desai JP, et al.Robotic surgery:a current perspective.Ann Surg, 2004, 239 (1):14-21.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Analysis of 12 Patients Undergoing Robot-assisted Pulmonary Lobectomy

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