Systematic Review of Published Studies on Safety and Efficacy of Thoracoscopic and Robot-Assisted Lobectomy for Lung Cancer

Abstract

The safety and effi cacy of thoracoscopic and robot-assisted lobectomies for primary lung cancer were reviewed in the literature. Thoracoscopic surgery is less invasive compared to thoracotomy, and it has been reported to be superior with regard to the outcome. In addition, the operability of a surgical robot (da Vinci) is favorable and supplements the disadvantages of conventional endoscopic surgery. Robot-assisted lobectomy has been reported to be comparable to thoracoscopic surgery with regard to the safety and effi cacy based on analysis of perioperative results and superior with regard to the operability and length of the learning curve. However, a high cost and a long operative time are of concern. Since robot-assisted surgery has been performed only in early cases, the continuation of a comparative investigation may be necessary.

Surgical outcomes associated with postoperative atrial fibrillation after robotic-assisted pulmonary lobectomy: retrospective review of 208 consecutive cases

“…The perioperative outcomes in our study are comparable to currently available literature on robotic-assisted pulmonary lobectomy. Nakamura (8) analyzed nine series of RAVTS lobectomies and pooled 693 cases total. In his analysis, the average operative time and conversion rate to open cases were 188 min and 8.8%, respectively.…”

Tips and tricks to decrease the duration of operation in robotic surgery for lung cancer

“…Its most visible benefits include a dramatic advance in visualization with magnified, highdefinition, three-dimensional imaging coupled with upgraded instrument maneuverability, building upon what have often been cited as critical weaknesses of video-assisted thoracoscopic surgery (VATS): limited, two-dimensional visualization along with restricted maneuverability (1,5,6). Moreover, robotic thoracic surgery has been demonstrated to reduce perioperative complications and hospital length of stay with similar effectiveness to open thoracotomy; direct comparisons to VATS, while limited, suggest similar efficacy (6)(7)(8)(9).…”

Great Vessel Injury in Thoracic Surgery

“…46 In a review of literature on safety and efficacy, robotic-assisted lobectomy was comparable to VATS, with robotic conversion to open in a range of 1.0% to 19.2% (mean 8.7%). 47,48 Cerfolio and colleagues 49 reported their experience on 106 robotic resections with 2 conversions for bleeding: one for pulmonary arterial bleeding to the anterior apical truncus during right upper lobectomy controlled with packing while converting, and another with parenchymal bleeding resulting from stapling during right upper lobe posterior segmentectomy. Park and colleagues 31 reported on 3 patients converted for minor bleeding events in a series of 325 robotic lobectomies, all initially controlled with direct "sponge-stick" compression through a utility incision while thoracotomy was performed.…”