Experience of robot-assisted lung segmentectomy through anterior approach_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TAO Shaolin , KANG Poming ,  TAN Qunyou , JIANG Bin , SHEN Cheng , FENG Yonggeng , FANG Chunshu , WU Licheng , LI Qingyuan , DENG Bo , WANG Ruwen

Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, P.R.China;

Corresponding author：

TAN Qunyou, Email: tanqy001@163.com

Keywords：

Pulmonary nodule; robot-assisted thoracic surgery; lung segmentectomy; minimally invasive surgery; operation approach

DOI：

10.7507/1007-4848.201912047

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the feasibility and clinical value of robot-assisted lung segmentectomy through anterior approach.Methods We retrospectively analyzed the clinical data of 77 patients who underwent robotic lung segmentectomy through anterior approach in our hospital between June 2018 to October 2019. There were 22 males and 55 females, aged 53 (30-71) years. Patients' symptoms, general conditions, preoperative imaging data, distribution of resected lung segments, operation time, bleeding volume, number of lymph node dissected, postoperative duration of chest tube insertion, drainage volume, postoperative hospital stay, postoperative complications, perioperative death and other indicators were analyzed.Results All operations were successfully completed. There was no conversion to thoracotomy, serious complications or perioperative death. The postoperative pathology revealed early lung cancer in 48 patients, and benign tumors in 29 patients. The mean clinical parameters were following: the robot Docking time 1-30 (M=4) min, the operation time 30-170 (M=76) min, the blood loss 20-400 (M=30) mL, the drainage tube time 2-15 (M=4) days, the drainage fluid volume 200-3 980 (M=780) mL and the postoperative hospital time 3-19 (M=7) days.Conclusion Robotic lung segmentectomy through anterior approach is a safe and convenient operation method for pulmonary nodules.

Citation： TAO Shaolin, KANG Poming, TAN Qunyou, JIANG Bin, SHEN Cheng, FENG Yonggeng, FANG Chunshu, WU Licheng, LI Qingyuan, DENG Bo, WANG Ruwen. Experience of robot-assisted lung segmentectomy through anterior approach. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(2): 178-182. doi: 10.7507/1007-4848.201912047 Copy

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2.	Hamet P, Tremblay J. Artificial intelligence in medicine. Metabolism, 2017, 69S: S36-S40.
3.	Zirafa CC, Romano G, Key TH, et al. The evolution of robotic thoracic surgery. Ann Cardiothorac Surg, 2019, 8(2): 210-217.
4.	He J. Strengthen the cancer surveillance to promote cancer prevention and control in China. Zhonghua Zhong Liu Za Zhi, 2018, 40(1): 1-4.
5.	Karki A, Shah R, Fein A. Multiple pulmonary nodules in malignancy. Curr Opin Pulm Med, 2017, 23(4): 285-289.
6.	Landreneau RJ, Schuchert MJ. Is segmentectomy the future? J Thorac Dis, 2019, 11(1): 308-318.
7.	Jensik RJ, Faber LP, Milloy FJ, et al. Segmental resection for lung cancer. A fifteen-year experience. J Thorac Cardiovasc Surg, 1973, 66(4): 563-572.
8.	Hennon M, Landreneau RJ. Role of segmentectomy in treatment of early-stage non-small cell lung cancer. Ann Surg Oncol, 2018, 25(1): 59-63.
9.	Zhang L, Li M, Yin R, et al. Comparison of the oncologic outcomes of anatomic segmentectomy and lobectomy for early-stage non-small cell lung cancer. Ann Thorac Surg, 2015, 99(2): 728-737.
10.	Pardolesi A, Veronesi G. Robot-assisted lung anatomic segmentectomy: technical aspects. Thorac Surg Clin, 2014, 24(2): 163-168.
11.	Nguyen D, Gharagozloo F, Tempesta B, et al. Long-term results of robotic anatomical segmentectomy for early-stage non-small-cell lung cancer. Eur J Cardiothorac Surg, 2019, 55(3): 427-433.
12.	Kalemkerian GP, Loo BW, Akerley W, et al. NCCN guidelines insights: small cell lung cancer, version 2.2018. J Natl Compr Canc Netw, 2018, 16(10): 1171-1182. .
13.	Diana M, Marescaux J. Robotic surgery. Br J Surg, 2015, 102(2): e15-e28.
14.	Yoshino I, Hashizume M, Shimada M, et al. Video-assisted thoracoscopic extirpation of a posterior mediastinal mass using the da Vinci computer enhanced surgical system. Ann Thorac Surg, 2002, 74(4): 1235-1237.
15.	冯刚, 李刚. 达芬奇手术机器人在胸外科的应用. 实用医院临床杂志, 2015, 12(1): 32-34.
16.	Anderson CA, Hellan M, Falebella A, et al. Robotic-assisted lung resection for malignant disease. Innovations (Phila), 2007, 2(5): 254-258.
17.	Cerfolio RJ, Watson C, Minnich DJ, et al. One hundred planned robotic segmentectomies: early results, technical details, and preferred port placement. Ann Thorac Surg, 2016, 101(3): 1089-1095.
18.	Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
19.	唐建, 喻本桐, 刘升, 等. 机器人辅助解剖性肺切除的初期经验与学习曲线. 中国胸心血管外科临床杂志, 2017, 24(7): 533-537.
20.	Terra RM, Lauricella LL, Haddad R, et al. Robotic anatomic pulmonary segmentectomy: technical approach and outcomes. Rev Col Bras Cir, 2019, 46(4): e20192210.
21.	Kitagawa M, Dokko D, Okamura AM, et al. Effect of sensory substitution on suture-manipulation forces for robotic surgical systems. J Thorac Cardiovasc Surg, 2005, 129(1): 151-158.
22.	Pardolesi A, Veronesi G, Solli P, et al. Use of indocyanine green to facilitate intersegmental plane identification during robotic anatomic segmentectomy. J Thorac Cardiovasc Surg, 2014, 148(2): 737-738.
23.	Doddoli C, Aragon A, Barlesi F, et al. Does the extent of lymph node dissection influence outcome in patients with stage Ⅰ non-small-cell lung cancer? Eur J Cardiothorac Surg, 2005, 27(4): 680-685.
24.	韩宇, 张亚杰, 李鹤成. 机器人辅助早期肺癌肺段手术的质量控制. 中国胸心血管外科临床杂志, 2019, 26(1): 16-20.
25.	Darling GE, Allen MS, Decker PA, et al. Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial. J Thorac Cardiovasc Surg, 2011, 141(3): 662-670.

1. Liu YH, Yao HW, Xin L. Give attention to both minimally invasive surgery and precision medicine to promote the scientificality on individualized clinical practice of rectal cancer. Zhonghua Wai Ke Za Zhi, 2016, 54(6): 404-407.
2. Hamet P, Tremblay J. Artificial intelligence in medicine. Metabolism, 2017, 69S: S36-S40.
3. Zirafa CC, Romano G, Key TH, et al. The evolution of robotic thoracic surgery. Ann Cardiothorac Surg, 2019, 8(2): 210-217.
4. He J. Strengthen the cancer surveillance to promote cancer prevention and control in China. Zhonghua Zhong Liu Za Zhi, 2018, 40(1): 1-4.
5. Karki A, Shah R, Fein A. Multiple pulmonary nodules in malignancy. Curr Opin Pulm Med, 2017, 23(4): 285-289.
6. Landreneau RJ, Schuchert MJ. Is segmentectomy the future? J Thorac Dis, 2019, 11(1): 308-318.
7. Jensik RJ, Faber LP, Milloy FJ, et al. Segmental resection for lung cancer. A fifteen-year experience. J Thorac Cardiovasc Surg, 1973, 66(4): 563-572.
8. Hennon M, Landreneau RJ. Role of segmentectomy in treatment of early-stage non-small cell lung cancer. Ann Surg Oncol, 2018, 25(1): 59-63.
9. Zhang L, Li M, Yin R, et al. Comparison of the oncologic outcomes of anatomic segmentectomy and lobectomy for early-stage non-small cell lung cancer. Ann Thorac Surg, 2015, 99(2): 728-737.
10. Pardolesi A, Veronesi G. Robot-assisted lung anatomic segmentectomy: technical aspects. Thorac Surg Clin, 2014, 24(2): 163-168.
11. Nguyen D, Gharagozloo F, Tempesta B, et al. Long-term results of robotic anatomical segmentectomy for early-stage non-small-cell lung cancer. Eur J Cardiothorac Surg, 2019, 55(3): 427-433.
12. Kalemkerian GP, Loo BW, Akerley W, et al. NCCN guidelines insights: small cell lung cancer, version 2.2018. J Natl Compr Canc Netw, 2018, 16(10): 1171-1182. .
13. Diana M, Marescaux J. Robotic surgery. Br J Surg, 2015, 102(2): e15-e28.
14. Yoshino I, Hashizume M, Shimada M, et al. Video-assisted thoracoscopic extirpation of a posterior mediastinal mass using the da Vinci computer enhanced surgical system. Ann Thorac Surg, 2002, 74(4): 1235-1237.
15. 冯刚, 李刚. 达芬奇手术机器人在胸外科的应用. 实用医院临床杂志, 2015, 12(1): 32-34.
16. Anderson CA, Hellan M, Falebella A, et al. Robotic-assisted lung resection for malignant disease. Innovations (Phila), 2007, 2(5): 254-258.
17. Cerfolio RJ, Watson C, Minnich DJ, et al. One hundred planned robotic segmentectomies: early results, technical details, and preferred port placement. Ann Thorac Surg, 2016, 101(3): 1089-1095.
18. Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
19. 唐建, 喻本桐, 刘升, 等. 机器人辅助解剖性肺切除的初期经验与学习曲线. 中国胸心血管外科临床杂志, 2017, 24(7): 533-537.
20. Terra RM, Lauricella LL, Haddad R, et al. Robotic anatomic pulmonary segmentectomy: technical approach and outcomes. Rev Col Bras Cir, 2019, 46(4): e20192210.
21. Kitagawa M, Dokko D, Okamura AM, et al. Effect of sensory substitution on suture-manipulation forces for robotic surgical systems. J Thorac Cardiovasc Surg, 2005, 129(1): 151-158.
22. Pardolesi A, Veronesi G, Solli P, et al. Use of indocyanine green to facilitate intersegmental plane identification during robotic anatomic segmentectomy. J Thorac Cardiovasc Surg, 2014, 148(2): 737-738.
23. Doddoli C, Aragon A, Barlesi F, et al. Does the extent of lymph node dissection influence outcome in patients with stage Ⅰ non-small-cell lung cancer? Eur J Cardiothorac Surg, 2005, 27(4): 680-685.
24. 韩宇, 张亚杰, 李鹤成. 机器人辅助早期肺癌肺段手术的质量控制. 中国胸心血管外科临床杂志, 2019, 26(1): 16-20.
25. Darling GE, Allen MS, Decker PA, et al. Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial. J Thorac Cardiovasc Surg, 2011, 141(3): 662-670.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Experience of robot-assisted lung segmentectomy through anterior approach

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