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Robotic Assisted Extended Pleurectomy And Decortication For Epithelioid Mesothelioma
M. Jawad Latif, Manzar Abbas, MD, Kostantinos Poulikidis, Faiz Bhora.
Hackensack Meridian JFK University Medical Center, Hackensack Meridian School of Medicine, Edison, NJ, USA.
Background: Surgical management of malignant pleural mesothelioma traditionally necessitates a morbid open thoracotomy for extended pleurectomy and decortication. While open surgery remains the standard, robotic-assisted platforms offer a minimally invasive alternative. We evaluate the feasibility of a robotic approach to achieve radical oncologic resection in locally advanced disease.
Methods: We present the case of a 62-year-old male with locally advanced epithelioid mesothelioma. Following induction chemotherapy, the patient underwent a total port robotic-assisted extended pleurectomy and decortication. The procedure included a comprehensive parietal and visceral pleurectomy and a partial-thickness resection of the right hemidiaphragm.
Results: Complete macroscopic resection was successfully achieved via the robotic approach. The platform"s enhanced visualization facilitated meticulous decortication of the diaphragmatic and costophrenic recesses. The patient experienced a streamlined postoperative recovery with significantly reduced morbidity compared to historical open cohorts. No perioperative complications were encountered.
Conclusion: Total robotic extended pleurectomy and decortication is a feasible and effective strategy for select cases of epithelioid mesothelioma. This approach preserves oncologic integrity while leveraging the benefits of minimally invasive surgery to improve perioperative outcomes and accelerate recovery.
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