Robotic left ventral segmentectomy.
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ABSTRACT:
SUBMITTER: Mangiameli G
PROVIDER: S-EPMC8350876 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-EPMC9735356 | biostudies-literature
Project description:When tumor is located in the superior segment of the lower lobe (S6) close to the intersegmental plane with the posterior basal segment (S10), bisegmentectomy of S6 and S10 is oncologically feasible and reasonable to preserve lung parenchyma. However, this bisegmentectomy is technically challenging because of the complex anatomy of S10. Herein, we report a successful case of left S6+S10 segmentectomy by a robotic approach with sufficient surgical margin. A robotic approach is suitable for such a complex segmentectomy of the lower lobe because of the good looking-up high-definition 3-dimensional view.
| S-EPMC11910831 | biostudies-literature
Project description: Not available
| S-EPMC8575848 | biostudies-literature
Project description:Use of low-dose CT scan allows detection of lung cancer at early stages, enabling a more conservative surgery and a better long-term survival in those patients. In this scenario, intentional anatomical segmentectomy is gaining consent over standard lobectomy among surgeons. A minimally invasive approach such as VATS reduced invasiveness and complication rate compared to open surgery, but this technique comes also with some disadvantages in terms of dexterity and intuitiveness. Robotic surgery allows to overcome those limitations, making segmentectomies easier and safer to perform. In addition, it offers the possibility to utilize intravenous indocyanine green to define the intersegmental plane, allowing a more precise surgery. We reviewed the literature and describe the technique of the robot assisted segmentectomy with a focus on the new technologies available nowadays.
| S-EPMC7330783 | biostudies-literature
Project description:BackgroundPulmonary segmentectomy for a lung with an incomplete interlobar fissure may complicate persistent air leakage. The fissureless technique is often used in lobectomy to prevent persistent air leakage. We herein describe successful use of the fissureless technique for segmentectomy with the aid of a robotic surgical system.Case presentationA 63-year-old man was clinically diagnosed with early-stage lung cancer for which lingular segmentectomy was indicated. A preoperative image revealed a lung with an incomplete fissure. Based on three-dimensional reconstruction imaging, we planned to divide the hilum structures in the order of the pulmonary vein, bronchus, and pulmonary artery and finally resect the lung parenchyma by dividing the intersegmental plane and interlobar fissure. This fissureless technique was successfully conducted using a robotic surgical system. The patient did not develop persistent air leakage and was alive without recurrence 1 year after segmentectomy.ConclusionsThe fissureless technique may be a useful option in segmentectomy for a lung with an incomplete interlobar fissure.
| S-EPMC10088251 | biostudies-literature
Project description: Not available
| S-EPMC9579802 | biostudies-literature
Project description:Segmentectomy has gained popularity in the latest years as a valid alternative to lobectomy. Initially reserved to patient unfit for lobar lung resection, this procedure is now offered also in selected patient with <2 cm peripheral lung cancer confined to an anatomic segment with no nodal involvement on preoperative evaluation. The introduction of screening with low-dose CT chest scan allowed the identification of lung cancer at early stages, making possible to schedule a more conservative lung surgery. A major improvement came also from minimally invasive surgery (MIS), reducing complication rate with comparable survival rates when compared to open surgery. However, due to long learning curve and uncomfortable instruments handling of video-assisted thoracoscopy, many surgeons still prefer to perform segmentectomies through a thoracotomy and thus increasing perioperative morbidity and leading to post-thoracotomy syndrome due to rib-spreading. Robotic assisted thoracic surgery (RATS) can avoid this throwback, combining the handling of open surgery with lesser invasiveness of thoracoscopy. Although literature has given strong evidences in favour of robotic lobectomies, data are still limited regarding segmentectomies performed with this technique. Moreover, no results are still available from the two ongoing randomized controlled trials comparing segmentectomy to lobectomy and so the latter represent the oncologically proper procedure for lung cancer along with lymph-node dissection. In this review we analyse the literature currently available on outcomes of lobar and sublobar anatomical resection performed by RATS, with a brief mention of the existing surgical techniques of port positioning and the costs of this procedure.
| S-EPMC8575815 | biostudies-literature
Project description:PurposesRobot-assisted thoracoscopic (RATS) segmentectomy is becoming increasingly common because of the expanded indications for segmentectomy and the widespread adoption of robotic surgery. The precise division of the intersegmental plane is necessary to ensure oncologic margins from the tumor and to preserve the lung function. In this study, we present a strategy for accurately dividing the intersegmental plane using a robotic stapler and review the surgical outcomes.MethodsRATS portal segmentectomy was performed using the Da Vinci Xi system and the intersegmental plane was dissected using a robotic stapler. We evaluated the perioperative outcomes in 92 patients who underwent RATS portal segmentectomy between May 2020 and January 2023. These results were compared with those of 82 patients who underwent complete video-assisted thoracoscopic surgery (CVATS) during the same period.ResultsThe operative and console times were 162 and 97 min, respectively. No intraoperative complications occurred, and postoperative complications were observed in four cases (4.3%). The operative time, blood loss, postoperative complications, and maximum incision size were significantly lower in the RATS group than in the CVATS group. However, RATS requires a significantly higher number of staplers than CVATS.ConclusionsThe division of the intersegmental plane using a robotic stapler in RATS portal segmentectomy was, therefore, found to be safe and effective.
| S-EPMC11499527 | biostudies-literature
Project description:BackgroundThe treatment strategy of multiple pulmonary nodules presents significant challenges in thoracic surgery, particularly regarding precise diagnosis and treatment. The integration of emerging technologies for concurrent hybrid diagnostic and therapeutic approaches represents a potential breakthrough. The purpose of this study is to provide a new paradigm for the synchronous mixed treatment of multiple pulmonary nodules.Case descriptionA 34-year-old female patient was initially diagnosed with multiple pulmonary nodules in August 2023 and has been undergoing regular follow-up since then. A computed tomography (CT) in September 2024 showed a mixed ground-glass nodule (mGGN) in the dorsal segment (S6) of the left lower lobe of the lung, measuring approximately 11 mm × 7 mm, indicating a high risk of malignancy; and a ground-glass opacity (GGO) measuring 5 mm × 4 mm between the dorsal segment and anterior basal segment (S6 and S8) of the right lower lobe, with both nodules showing enlargement compared to a year ago. A simultaneous bilateral lung surgery is planned. The Ion robotic system was utilized to navigate precisely to the lesion along the B6b bronchus of the right lower lobe, where the lung nodule was ablated with a laser. Subsequently, the Da Vinci robotic system used to assist in the precise resection of the S6. Pathology on the left showed adenocarcinoma; a CT one week postoperatively showed a 1 cm patchy shadow with a cavity on the right.ConclusionsThis report presents the first surgical technique for ion robotic-assisted laser ablation and dual-robot collaborative surgery, offering a novel strategy for the integration of airway diagnostic and therapeutic interventions.
| S-EPMC11921196 | biostudies-literature
Project description:BackgroundRobotic anatomic segmentectomy (RATS) for early-stage lung cancer is being increasingly performed in spite of limited published evidence. To evaluate its safety and oncologic efficacy, we compared the outcomes of both RATS and video-assisted thoracoscopic (VATS) segmentectomy in patients with small-sized (<2 cm) peripheral stage IA lung cancer.MethodsFrom November 2011 to January 2018, a total of 130 patients with resected stage IA non-small cell lung cancer (NSCLC) who underwent RATS (n=50) and VATS (n=80) pulmonary segmentectomy were included. Clinicopathologic data, recurrence rate, and survival were recorded.ResultsThe demographics, pulmonary function, comorbidity, and tumor size were similar between RATS segmentectomy and VATS segmentectomy. The surgery time, intensive care unit stay, hospital stay, and blood loss were reduced in the RATS group compared to the VATS group. The number of totally dissected lymph nodes and postoperative complications were similar between the 2 groups. There was no operative mortality. The intensity of narcotic use during hospital stay and the time to return to routine daily activities were also reduced in the RATS group. There was no recurrence observed in the RATS group during the median 38-month follow-up period; meanwhile, during a median 85-month follow-up period in the VATS group, local recurrence and distant recurrence was observed in 2 patients (2.5%) and 3 patients (3.75%) respectively. There was no significant difference in the 5-year recurrence-free survival between the RATS and VATS groups (100% vs. 93.75%; P>0.05).ConclusionsRATS can be performed safely and effectively in patients with early-stage NSCLC. The reduced narcotic use and earlier return to routine daily activities of RATS patients might reflect its less traumatic nature as compared to VATS. For stage IA disease with small tumors (<2 cm), segmentectomy performed by RATS has better oncologic efficacy when compared to VATS, although in this study, this difference did not reach statistical difference.
| S-EPMC7225141 | biostudies-literature