Robotic approach in case of thymoma involving the left anonymous vein: a case report

Abstract

The robotic system has several technical advantages over the manual video thoracoscopic approach. It offers a high definition three-dimensional view and robotic arms are more comfortable to use, because they allow more precise, flexible, and intuitive movements. This case report describes a locally advanced thymoma in a 75-year-old male patient, excised through a robotic-assisted thymectomy with atypical resection of the infiltrated left upper lobe, the preservation of the left phrenic nerve and partial resection of the left anonymous vein involved, without necessity of reconstruction. Clinical staging was thymoma T3 B1-2, while the postoperative histological classification and radiation was thymoma T3, B3, Masaoka-Koga stage IIB. The postoperative course was uneventful and the patient was discharged in second postoperative day. This case remarks that robotic devices are of great help in the intraoperative recognition and precise management of infiltrated structure, like important vessels and nerves, avoiding conversion to an open approach, which until now was the main surgical indication in these situations.

ERS International Congress 2020: highlights from the Thoracic Surgery and Transplantation Assembly

“…In fact, RATS is associated with lower mortality rate compared with open surgery and VATS, improved quality of life and reduced pain compared to open surgery, improved lymph node dissection and radicality regarding either anatomic segmentectomy [ 2 ] or a more extended resection for locally advanced non-small cell lung cancer [ 3 ] compared with VATS, with similar oncological outcomes. Furthermore, RATS provides enhanced outcomes when applied in complex cases and thymectomy in myasthenic patients [ 4 ]. Finally, it was demonstrated that both VATS and RATS are associated with similar costs when complications, length of stay and readmissions are taken into consideration.…”

Robot-assisted en bloc anterior mediastinal mass excision with pericardium and adjacent lung for locally advanced thymic carcinoma

“…In these locally advanced cases, en bloc thymectomy by median sternotomy has been considered as the standard approach. However, the evolutionary development of robotic systems and the accumulation of robotic surgery experience have allowed some experienced robotic surgeons to approach more complex and difficult cases with these techniques (4)(5)(6)(7).…”