Appropriate set-up of the da Vinci Surgical System in relation to the location of anterior and middle mediastinal tumors.

The da Vinci® Surgical System (dV) and its later version [da Vinci S® Surgical System (dVS)] have been used only in very few cases in selected thoracic surgical areas in Japan. Recently, we used the dV and dVS for various types of anterior and middle mediastinal tumors in clinical practice. We report our experience, and review the settings which depended on tumor location. Six patients gave written informed consent to undergo robotic surgery using the dV or dVS. We evaluated the feasibility, safety and appropriate settings of this system for the surgical treatment of mediastinal tumors. Tumor dissection was performed by two specialists in thoracic surgery certified to use the dV and dVS, and another specialist who acted as an assistant. We were able to access difficult-to-reach areas like the mediastinum. All the resected tumors were classified as benign tumors histologically. Crucial to the success of these operations was the set-up of the dV, which varied according to the location of mediastinal tumors. Robotic surgery enables various types of mediastinal tumor dissection more safely and easily than conventional video-assisted thoracoscopic surgery (VATS). The dV requires the appropriate set-up configuration, which varies according to the location of the mediastinal tumor.