First Reported Robotic Assisted Enbloc Resection Of Right Lower Lobe With Posterior Segmentectomy Of Right Upper Lobe
Amie Kent, MD, Byron Patton, MD, Richard Lazzaro, MD.
Northwell Health - Lenox Hill Hospital, New York, NY, USA.
OBJECTIVE: This video demonstrates a robotic assisted right VATS right lower lobectomy with enbloc resection of anatomic posterior segmentectomy for a biopsy proven adenocarcinoma of the lung.
METHODS: 72 year old female diagnosed with a right lower lobe tumor during a hospitalization where she had an ERCP for choledocholithiasis and developed post ERCP pancreatitis. After she recovered, repeat imaging demonstrated a right lower lobe spiculated mass 5x4.5 x2.9cm. Metastatic work up revealed no evidence of mediastinal or extrathoracic disease. The procedure was performed as a robotic assisted right VATS using five ports, four for the robotic arms and one access port. The tumor was emanating from the right lower lobe and had direct extension into the posterior segment of the right upper lobe, ultimately an enbloc posterior segmentectomy of the right upper lobe was performed with the right lower lobectomy, and completion mediastinal lymph node dissection.
RESULTS: Patient tolerated the procedure well and was discharged home on post-operative day two. Final pathology demonstrated a pT2bN0M0, 6cm adenocarcinoma invading the visceral pleura and crosses the interlobar fissure into the upper lobe. The bronchial, vascular, and parenchymal margins were negative for tumor. Patient recovered well and is planned to start systemic therapy.
CONCLUSIONS: We report the first case of a robotically performed enbloc resection of the right lower lobe with posterior segmentectomy of the right upper lobe with adequate oncologic outcomes.
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