Back to 2025 Thoracic Abstracts
Robotic Lung Volume Reduction Surgery (LVRS) Using A Single Port Robotic Platform: Approaching Maximum Minimally Invasiveness
Mohsin E. Jawed, MD, Neelesh Bagrodia, MD, Desmond D'Souza, MD.
Ohio State University Wexner Medical Center, Columbus, OH, USA.
BACKGROUND: Lung volume reduction surgery (LVRS) has been shown to improve symptoms, exercise tolerance, and overall quality of life in patients with chronic obstructive pulmonary disease (COPD) and upper-lobe predominant emphysema. The authors report a successful case of robotic bilateral LVRS using a single port robotic platform which, to their knowledge, has not previously been described.
METHODS: Using a single port robotic platform, a 73 year old female successfully underwent robotic bilateral LVRS via a 4cm subcostal incision on each side (as indicated in the accompanying image). The best results at establishing access were achieved using a wound protector-access port apparatus, which accommodates the biarticulating endoscope and working arms of the single port robotic system. A 12mm counter incision was necessary in the 5th intercostal space, in order to allow access for a handheld stapler across the lung parenchyma. This site was later converted to a chest tube site, and the subcostal incision was closed in multiple layers with resulting excellent cosmesis.
RESULTS: Postoperatively, the patient was extubated in the operating room and experienced an uneventful course. Pain control was achieved through a multimodal approach that minimized narcotics, including intraoperative intercostal nerve blocks and bupivacaine patient-controlled epidural analgesia aimed at spinal levels T6-T7. She recovered without complications.
CONCLUSIONS: Minimally invasive robotic LVRS is feasible utilizing a single port robotic platform. As these systems develop to further accommodate stapling devices, the authors anticipate development of a platform that can truly be achieved through a singular subcostal incision with fully robotic control.
LEGEND: Setup for single port robotic lung volume reduction surgery. A, 4cm planned subcostal incision between the mid-clavicular and anterior axillary line, orthogonal to the 7th and 8th intercostal spaces
. B, insertion of 25mm single port metal robotic port as well as a 12mm trocar in the 5th intercostal space
. C, docked single port robotic system with the wound protector-access port apparatus replacing the metal port
. D, final appearance after wound closure and chest tube placement
.
Back to 2025 Thoracic Abstracts
