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International Society For Minimally Invasive Cardiothoracic Surgery

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Robot Assisted Right Upper Lobe Sleeve Lobectomy
Farhan Nadeem, Charles Bakhos, Roman Petrov, Abbas Abbas
Temple University Hospital, Philadelphia, PA, USA

BACKGROUND - Sleeve lobectomy is a lung sparing procedure with alternative being pneumonectomy for centrally located lung tumors. Compared to pneumonectomy, sleeve resection has been shown to be associated with improved survival in carefully selected patients. Considering the complexity of the procedure, bronchial sleeve resections are mainly performed open across the globe. While improving survival and preserving post operative pulmonary function, sleeve lobectomies have been associated also with improved surgical outcomes, though this might be prone to selection bias. Compared to open approach, minimally invasive approach to lung resections has been to shown to be advantageous in many studies. Performance of sleeve lobectomy using traditional thoracoscopic techniques is technically challenging and robot assisted approach provides application of the robotic platform to perform difficult surgery safely.
METHODS - 68 year old Female smoker presented with incidental finding of right lung lesion seen on chest X ray. CT scan showed the lesion in question to be located centrally in right upper lobe. Bronchoscopy and biopsy showed an endoluminal squamous cell carcinoma in situ of right upper lobe. A decision was made to perform robot assisted right upper lobe sleeve lobectomy.
RESULTS - Robot assisted technique of right upper lobe sleeve lobectomy is described in detail in the video.
CONCLUSIONS - Robot assisted sleeve lobectomy is technically feasible and is an attractive option for centrally located lung lesions. In addition to providing better visualization in narrow space, it amplifies manual dexterity especially when it comes to the performance of bronchial anastomosis.


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