Hybrid robotic thoracic surgery for excision of large mediastinal masses.

Journal of visualized surgery Pub Date : 2018-05-18 eCollection Date: 2018-01-01 DOI:10.21037/jovs.2018.05.17
Dario Amore, Marcellino Cicalese, Roberto Scaramuzzi, Davide Di Natale, Dino Casazza, Carlo Curcio
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引用次数: 3

Abstract

Between April 2016 and October 2017, we retrospectively reviewed all patients undergoing excision of large mediastinal masses using a hybrid robotic thoracic approach at the Unit of Thoracic Surgery of Monaldi Hospital in Naples. The inclusion criteria for this approach were: evident unilateral predominance of the mass; absence of invasion to surrounding structures. Planned conversion to sternotomy was necessary in one patient for tenacious adhesions between the mediastinal goiter and the left innominate vein. In all cases the postoperative course was uneventful. The hybrid robotic approach, adopted in our Unit, consists of a thoracic procedure performed completely with articulated surgical instruments under three-dimensional vision and followed by final extension of a port-site incision to retrieve the voluminous specimen. This approach uses all the advantages of robotic technology that enables to perform a fine dissection in the small space of the anterior mediastinum and at the same time, through the simple extension of a minimally invasive access, avoids the painful sequelae of thoracotomy. In selected cases, with increased experience in robotic surgery, it can be proposed for excision of large mediastinal masses, although a longer follow-up period is necessary to validate our findings.

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混合机器人胸腔手术切除大纵隔肿块。
2016年4月至2017年10月,我们回顾性分析了所有在那不勒斯Monaldi医院胸外科采用混合机器人胸外科入路切除大纵隔肿块的患者。该入路的入选标准为:肿块明显单侧优势;对周围结构无侵犯。计划转换到胸骨切开术是必要的,在一个病人之间的顽固粘连纵隔甲状腺肿和左无名静脉。所有病例的术后过程均平安无事。本单位采用的混合机器人入路包括在三维视觉下完全用关节手术器械完成的胸部手术,然后最后延长端口切口以取出体积大的标本。该方法利用了机器人技术的所有优点,能够在前纵隔的小空间内进行精细的解剖,同时,通过简单的微创通道延伸,避免了开胸手术的痛苦后遗症。在选定的病例中,随着机器人手术经验的增加,可以建议切除大型纵隔肿块,尽管需要更长的随访时间来验证我们的发现。
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