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Robotic Assisted Tracheal Reconstruction
Shamele Battan-Wraith, Evelyn Alexander, Ahmed Elkamel, Stephanie Worrell, Praveen Sridhar.
University of Arizona, Tucson, AZ, USA.

This video demonstrates a robotic-assisted tracheal reconstruction in a 54-year-old female with complex tracheal stenosis secondary to prolonged intubation following DKA. After multiple failed dilations and progressive stridor, she was selected for definitive surgical intervention with intraoperative VV-ECMO support. This represents a real-world case of robotic tracheal salvage in the setting of recurrent, fibrotic stenosis, highlighting the importance of patient selection and multidisciplinary collaboration across pulmonology, anesthesia, ECMO, and thoracic surgery. Certain components of the case, including ECMO cannulation and open tracheal mobilization, are not demonstrated in the video but are critical to the overall approach. Cannulation was performed via bilateral femoral veins, and VV-ECMO facilitated safe extubation and intraoperative oxygenation. Open dissection extended to the carina to address distal fibrosis. Key robotic steps included port placement, precise circumferential mobilization, and tension-free tracheal anastomosis with enhanced visualization. This video emphasizes reproducible techniques and decision-making strategies that may inform surgical planning in similarly complex airway cases.

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