Starting experience in robotic thoracic surgery

Abstract

Background: The robotic assisted thoracoscopic surgery (RATS) spreads rapidly across the whole world. In this paper, the objective was to present the training experience on RATS in our clinic along with the literature. Materials and Methods: Sixty-three consecutive patients, who had undergone RATS between February 2014 and December 2018, were included in this retrospective non-randomized study. The training period was designed as three phases. Twelve patients with solid and cystic mass lesions in the mediastinum and chest wall were included in group Phase 1. The group Phase 2 consisted of 16 patients who had thymoma and benign pulmonary mass lesions, and 35 consecutive patients were enrolled into group Phase 3 group who had undergone lobectomy. Results: The patients in all groups were compared in respect of the preoperative, perioperative and postoperative results. The docking time was significantly shorter in Phase 3 patients compared to the groups Phase 1 and 2 (p < 0.05). In the lobectomy group (Phase 3), as the console time and operation time was significantly shorter after the 20th patient than the prior patients, first 20 patients were accepted as the learning curve (p < 0.05). In the lobectomy group, in three patients the operation was converted to open surgery during the perioperative period (4.7%). No mortality was observed during the 30-day follow-up. One patient died in the 6 th month of the long-term follow-up. The mean follow-up duration was 28.4 months. Conclusions: RATS is a safe, feasible, and minimally invasive method, which has low complication rates with a satisfying and short learning curve.

Robot-assisted lobectomy versus completely portal robotic lobectomy: What is the difference?

“…The access port (AP), which was covered by a soft tissue skin retractor, was placed at the 5 th ICS on the midclavicular line and used for the suction, lung retraction, and specimen removal by the bed surgeon. [ 5 ]…”