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Objective:
We present our early results of complex thoracic surgery using the Da Vinci robotics.
Method:
Between January 2013 to January 2014, 106 patients underwent complex thoracic surgery using the DaVinci 4 arm robot. Patient and surgeon’s satisfaction questionnaires were evaluated. Results were compared with case matched group of 100 patients undergoing VATS.
Results:
The surgeries performed using the Da Vinci HDSi system were:
Robotic Thymectomy for Thymoma, Myasthenia, Lobectomy for lung cancer, aspergilloma, post tubercular bronchiectasis, Segmentectomy , sleeve lobectomy, Pneumonectomy, Resection of Ectopic Parathyroid adenoma, Metastatectomy, mediastinal, chest wall & thoracic outlet cysts & tumours, plication of diaphragm and ligation of thoracic duct.
The mean hospital stay was 3 days (range 3-7), with 10 conversions to VATS, 4 to open
One tension pneumothorax required urgent undocking of robot.
2 bleeding patients needed control with VATS
The advantages of robotics included better 3D visualization, higher dexterity of the robotic arm, lesser pain and equal cosmesis. The ability to suture with Robotics was superior.
No major wound infection was reported in both the groups. Drain dwell time was equal (Mean: 1 day). No difference in air leak between the two groups. No significant difference in Mean hospital stay (mean 3 days).
Conclusion: Robotic thoracic surgery offers similar clinical results as VATS but with added benefits of better visualization, dexterity and ability to suture. Cosmetics, early hospital discharge and reduced pain continue to be strengths of both types of procedures.