Ricardo Mingarini Terra1,2, Leticia Leone Lauricella1,3,4, Rui Haddad2,5,6, José Ribas Milanes de-Campos3,7, Pedro Henrique Xavier Nabuco-de-Araujo1,3,4, Carlos Eduardo Teixeira Lima2,5,6, Felipe Carvalho Braga Dos Santos5,6, Paulo Manuel Pego-Fernandes1,7. 1. Hospital Sírio Libanês, Serviço de Cirurgia Torácica, São Paulo, SP, Brasil. 2. Pontifícia Universidade Católica do Rio de Janeiro, Escola Médica de Pós-Graduação, Disciplina de Cirurgia Torácica, Rio de Janeiro, RJ, Brasil. 3. Universidade de São Paulo, Faculdade de Medicina, Disciplina de Cirurgia Torácica, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brasil. 4. Hospital São Luiz Itaim - Rede D'Or, Serviço de Cirurgia Torácica, São Paulo, SP, Brasil. 5. Hospital Copa Star, Serviço de Cirurgia Torácica, Rio de Janeiro, RJ, Brasil. 6. Hospital Quinta D'Or - Rede D'Or, Serviço de Cirurgia Torácica, Rio de Janeiro, RJ, Brasil. 7. Hospital Israelita Albert Einstein, Serviço de Cirurgia Torácica, São Paulo, SP, Brasil.
Abstract
OBJECTIVE: to report our initial experience with pulmonary robotic segmentectomy, describing the surgical technique, the preferred positioning of portals, initial results and outcomes. METHODS: we collected data, from a prospective robotic surgery database, on patients undergoing robotic segmentectomy between January 2017 and December 2018. All patients had lung cancer, primary or secondary, or benign diseases, and were operated on with the Da Vinci system, by the three portals technique plus one utilitarian incision of 3cm. We dissected the hilar structures individually and performed the ligatures of the arterial and venous branches, of the segmental bronchi, as well as a parenchymal transection, with endoscopic staplers. We carried out systematic dissection of mediastinal lymph nodes for non-small cell lung cancer (NSCLC) cases. RESULTS: forty-nine patients, of whom 33 were women, underwent robotic segmentectomy. The average age was of 68 years. Most patients had NSCLC (n=34), followed by metastatic disease (n=11) and benign disease (n=4). There was no conversion to laparoscopic or open surgery, or to lobectomy. The median total operative time was 160 minutes, and the median console time, 117 minutes. Postoperative complications occurred in nine patients (18.3%), of whom seven (14.2%) had prolonged hospitalization (>7 days) due to persistent air fistula (n=4; 8.1%) or abdominal complications (n=2.4%). CONCLUSION: robotic segmentectomy is a safe and viable procedure, offering a short period of hospitalization and low morbidity.
OBJECTIVE: to report our initial experience with pulmonary robotic segmentectomy, describing the surgical technique, the preferred positioning of portals, initial results and outcomes. METHODS: we collected data, from a prospective robotic surgery database, on patients undergoing robotic segmentectomy between January 2017 and December 2018. All patients had lung cancer, primary or secondary, or benign diseases, and were operated on with the Da Vinci system, by the three portals technique plus one utilitarian incision of 3cm. We dissected the hilar structures individually and performed the ligatures of the arterial and venous branches, of the segmental bronchi, as well as a parenchymal transection, with endoscopic staplers. We carried out systematic dissection of mediastinal lymph nodes for non-small cell lung cancer (NSCLC) cases. RESULTS: forty-nine patients, of whom 33 were women, underwent robotic segmentectomy. The average age was of 68 years. Most patients had NSCLC (n=34), followed by metastatic disease (n=11) and benign disease (n=4). There was no conversion to laparoscopic or open surgery, or to lobectomy. The median total operative time was 160 minutes, and the median console time, 117 minutes. Postoperative complications occurred in nine patients (18.3%), of whom seven (14.2%) had prolonged hospitalization (>7 days) due to persistent air fistula (n=4; 8.1%) or abdominal complications (n=2.4%). CONCLUSION: robotic segmentectomy is a safe and viable procedure, offering a short period of hospitalization and low morbidity.