Back to Annual Meeting Posters

BACKGROUND: The conventional approach to the diagnosis of mediastinal masses is associated with a high level of inaccuracy and the need for multiple interventions. Robotics has the potential of providing a highly accurate approach to the diagnosis and management of mediastinal masses.
METHODS: From 9/05- to 6/11, 54 patients were diagnosed with a mediastinal mass and underwent transthoracic robotic biopsy and, if appropriate, robotic resection.
RESULTS: There were 23 anterior, 22 mid, and 9 posterior mediastinal masses. Of the anterior mediastinal masses, 18 were thymic in origin, 2 lymphomas, 2 germ cell, and 1 cavernous hemangioma. Mid mediastinal masses: 12 lymphatic in origin and 10 aerodigestive cysts. Of the posterior mediastinal masses: 3 neurogenic, 1 thyroid goiter, and 5 benign cysts. The robotic approach was from the right pleural space in 37 patients and from the left pleural space in 17 patients. The sensitivity of the robotic technique was 98% and specificity was 100%. 34 patients underwent simultaneous robotic resection of the mass. Two patients required conversion to an open procedure. Mean operative time was 187 +/- 41 minutes. Postoperative complications were seen in 9% of patients which included pneumonia, atrial fibrillation, ileus, hemothorax, and pneumothorax. There was no mortality. Median length of hospital stay was 4 days.
CONCLUSION: Robotic approach to the diagnosis and treatment of mediastinal masses is associated with high sensitivity and specificity for diagnosis. Furthermore, in patients in whom resection of the mass is indicated, the robot can be used for resection in the same operative setting.