Bronchial sleeve anastomosis and primary closures with the da Vinci system: an advanced minimally invasive technique

Cosgun, Tugba; Kaba, Erkan; Ayalp, Kemal; Alomari, Mazen Rasmi; Toker, Alper

doi:10.21037/vats.2017.08.06

Cited by 5 publications

(10 citation statements)

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“…By the time, more complex cases, such as those with incomplete fissures, previous thoracic surgeries, obese body habitus, and moderate-severe pleuropulmonary adhesions, have been performed. 24,28 The major difference in our study compared with others was the selection of a unique procedure. This procedure has been considered to be relatively complex when performed with minimally invasive techniques.…”

Section: Discussionmentioning

confidence: 90%

“…Superiorities, such as better flexibility, due to EndoWrist instruments, more intuitive movements, and high-definition three-dimensional vision, increased the use of robotic platform in thoracic surgery. 24 These superiorities may help a surgeon in performing more complicated cases, such as bronchial sleeve resections. 25 We claimed that LC and proficiency level are different in thoracic surgery.…”

Section: Discussionmentioning

confidence: 99%

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Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary Resection

Cosgun

Kaba

Ayalp

et al. 2019

Thorac Cardiovasc Surg

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Background Robot technology is a revolutionary technique to overcome limitations of minimal invasive surgery. The proficiency level varies from study to study. We considered the first sleeve lobectomy as a benchmark procedure to evaluate the proficiency level. Methods We retrospectively analyzed 197 patients who underwent robot-assisted thoracoscopic surgery (RATS) for primary lung cancer between December 2011 and May 2018. Patients were divided into two groups based on undergoing surgery earlier period (EP) or later period (LP) than the first sleeve lobectomy by RATS (May 25, 2015). The preoperative, operative, and short- and long-term postoperative outcomes were compared. Seven-year survival was also compared between two periods for T1N0 and T2N0 diseases. Results Preoperative features were similar. The mean operative time was 166.8 ± 55.1 and 142.4 ± 43.9 minutes in EP and LP, respectively (p = 0.005). The mean number of dissected lymph nodes in LP was also significantly higher than that in EP (24.4 ± 9.4 vs. 20.8 ± 10.4, p = 0.035). The complication rate was significantly lower in LP (29/86 vs. 25/111, p = 0.048). The extended resection (ER) rate was significantly higher in LP (p = 0.023). The 7-year survival was comparable in EP and LP in both patients with T1N0 and T2N0 (p = 0.28 and p = 0.11, respectively). Conclusion Perioperative outcomes, such as duration of surgery, number of dissected lymph nodes, complications, and ERs are favorable in patients who underwent surgeries after the first sleeve resection. The first sleeve lobectomy may be considered as the benchmark procedure for the proficiency level in RATS.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary Resection

Cosgun

Kaba

Ayalp

et al. 2019

Thorac Cardiovasc Surg

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“…Results of widespread use of this type of wire in bronchial anastomosis should be published. Durand et al and Cosgun et al found no issues in their robotic sleeve procedures with this type of wire, Nakagawa et al had one anastomotic stenosis out of a total of four cases, not needing any reintervention (11,13,14). Another advantage of the robotic platform is the ease of the lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

Robotic assisted thoracoscopic middle lobe sleeve resection: a case report

Decaluwé¹

2022

J Vis Surg

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We present a case of a typical carcinoid located in the origin of the bronchus of the middle lobe, treated with a robotic assisted sleeve resection of the middle lobe. The patient presented with a middle lobe pneumonia followed by an episode of haemoptysis. The patient had a speedy recovery after surgery.Lung function was normal at one year, CT-scan confirmed a patent bronchial anastomosis without signs of recurrence. Middle lobe bronchial sleeve resections are uncommonly performed. In selected patients, they are an alternative to a right lower bilobectomy, saving the lower lobe and a significant amount of lung function. The middle lobe bronchus orifice lies in close proximity to those of the basal segments and segment 6 of the lower lobe, making an anastomosis of the bronchus of the lower lobe and the intermediate bronchus technically challenging. Access can be hampered by the overlying pulmonary artery. A robotic platform can help to overcome these technical burdens. Middle lobe bronchial sleeve resections with anastomosis of the lower lobe bronchus to the intermediate bronchus is technically feasible in selected patients, a robotic platform can help to overcome some technical issues and achieve a successful outcome.

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“…Approximately 8% of the resections for primary lung cancer are sleeve resections (9). It is reported that the most common and technically easiest sleeve resection is right upper sleeve lobectomy (9).In our experience with robotic surgery, most of the sleeve lobectomies are right upper lobe sleeves; although, as of now, sleeve lobectomies for all single lobes exist (10).…”

Section: Introductionmentioning

confidence: 94%

Left upper and left lower sleeve lobectomies with robotic surgery

Toker¹,

Kaba²,

Herron³

et al. 2021

J Vis Surg

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Surgical resection provides the highest possible survival in non small cell lung cancer (NSCLC).To allow negative margins for tumors extending into the lobar bronchus, sleeve resections can be performed with the potential for better early and late outcomes. This would also include an invasive N1 lymph node.Because of better flexibility due to endowrist instruments and high definition with three-dimensional viewing sleeve resections could be performed with the surgical robot. Two cases of left sleeve lobectomies, one left lower and one left upper, will be described in this study. The results of our study suggest that when sleeve resection is required during surgery for lung cancer, the procedure can be safely performed with robotassisted thoracoscopic surgery. In the classical knowledge for minimally invasive surgery, conversion to open surgery was recommended in the previous decade. Some reports with VATS have been presented for sleeve resections. However, utilization of this technique has been a rare indication. Based on our experience, we claim that conversion to thoracotomy would not be required if the surgical robot has been used. In this manuscript, literature findings were discussed.

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Bronchial sleeve anastomosis and primary closures with the da Vinci system: an advanced minimally invasive technique

Cited by 5 publications

References 0 publications

Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary Resection

Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary Resection

Robotic assisted thoracoscopic middle lobe sleeve resection: a case report

Left upper and left lower sleeve lobectomies with robotic surgery

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