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Complex left upper lobectomy with lymphadenectomy by robotic assisted thoracoscopy (CPRL-3) for cT2N2 non-small-cell lung carcinoma (NSCLC)
This video demonstrates a left upper lobectomy for the management of a proximal cT2N2M0 lung tumor. It is usually considered a contraindication of minimally invasive surgery. Our aim is to show the feasibility and the safety of the procedure. Robotic surgery will allow for more minimally invasive indications.
The tumor lies proximally to the left trunk of the pulmonary artery which could be a contraindication to a minimally invasive surgery. A CT-scan combined with a 3D reconstruction helps to rule out the existence of pulmonary artery invasion. Hilar adenopathies as well as adenopathies of the aortopulmonary window present a hypermetabolism on PET-scan. No neoadjuvant chemotherapy is performed since a R0 surgery is potentially feasible immediately and can be associated with a full lymphadenectomy.
This video presents our technique of robotically assisted left upper lobectomy combined with a lymph node dissection. We have attempted to standardize our lung resection technique using 6 areas of dissection to gain in efficacy and save time. The first operative step is to free the triangular ligament and to sample potential lymph nodes (station No. 9). A hilar lymphadenectomy (lymph node station No. 10) is then performed using a posterior approach first followed by a subcarinal approach (lymph node #7, by skeletonizing the pulmonary artery and the left main bronchus. The third step of the procedure is to dissect the fissure to skeletonize the pulmonary artery and its lingular branches as well as branches of the posterior fissure, dissection of lymph node stations No. 11 is performed simultaneously. The elements of the hilum are then approached using an anterior approach. The superior pulmonary vein is dissected. The roof of the hilum is then freed. The left upper bronchus is divided last. Dissection of lymph node station No. 5 completes the procedure with preservation of the left recurrent nerve
Abbreviation:
CPRL-3: complete portal robotic lobectomy using 3 arms
J Cahais, JM Baste, C Peillon
Surgical intervention
4 years ago
758 views
18 likes
0 comments
11:07
Complex left upper lobectomy with lymphadenectomy by robotic assisted thoracoscopy (CPRL-3) for cT2N2 non-small-cell lung carcinoma (NSCLC)
This video demonstrates a left upper lobectomy for the management of a proximal cT2N2M0 lung tumor. It is usually considered a contraindication of minimally invasive surgery. Our aim is to show the feasibility and the safety of the procedure. Robotic surgery will allow for more minimally invasive indications.
The tumor lies proximally to the left trunk of the pulmonary artery which could be a contraindication to a minimally invasive surgery. A CT-scan combined with a 3D reconstruction helps to rule out the existence of pulmonary artery invasion. Hilar adenopathies as well as adenopathies of the aortopulmonary window present a hypermetabolism on PET-scan. No neoadjuvant chemotherapy is performed since a R0 surgery is potentially feasible immediately and can be associated with a full lymphadenectomy.
This video presents our technique of robotically assisted left upper lobectomy combined with a lymph node dissection. We have attempted to standardize our lung resection technique using 6 areas of dissection to gain in efficacy and save time. The first operative step is to free the triangular ligament and to sample potential lymph nodes (station No. 9). A hilar lymphadenectomy (lymph node station No. 10) is then performed using a posterior approach first followed by a subcarinal approach (lymph node #7, by skeletonizing the pulmonary artery and the left main bronchus. The third step of the procedure is to dissect the fissure to skeletonize the pulmonary artery and its lingular branches as well as branches of the posterior fissure, dissection of lymph node stations No. 11 is performed simultaneously. The elements of the hilum are then approached using an anterior approach. The superior pulmonary vein is dissected. The roof of the hilum is then freed. The left upper bronchus is divided last. Dissection of lymph node station No. 5 completes the procedure with preservation of the left recurrent nerve
Abbreviation:
CPRL-3: complete portal robotic lobectomy using 3 arms
Video-assisted thoracoscopic (VATS) lobectomy: left lower lobe
Standard treatment of early-stage non-small cell lung cancer (NSCLC) involves anatomic pulmonary lobectomy and mediastinal lymph node dissection. Traditionally, this procedure has been carried out via a posterior lateral thoracotomy, requiring division of chest wall muscles and rib spreading. This is frequently associated with chronic postoperative pain, which may become incapacitating in 5% of patients.
One of the major potential advantages of video-assisted thoracoscopic (VATS) lobectomy is decreasing the incidence of chronic post-thoracotomy pain.
Key aspects of the procedure include the following:
- proper patient positioning;
- access to the pleural cavity and appropriate positioning of operating incisions;
- careful dissection of pulmonary arterial branches, using a “fissure-sparing” technique whenever possible to decrease the incidence of prolonged postoperative air leaks;
- division of lung parenchyma, blood vessels, and bronchus using endoscopic staplers.
The VATS approach can be performed with lower morbidity and an equivalent or better oncologic outcome to traditional open surgery. We present a VATS lobectomy for a carcinoid tumor of the left lower lobe in a 42-year-old patient. The video lays emphasis on the steps of lobe resection; mediastinal lymph node dissection was performed but is not shown.
Acknowledgment: we would like to thank Nathalie Leroux RN and Suzanne Desbiens for their continued support.
G Rakovich
Surgical intervention
4 years ago
828 views
85 likes
0 comments
08:05
Video-assisted thoracoscopic (VATS) lobectomy: left lower lobe
Standard treatment of early-stage non-small cell lung cancer (NSCLC) involves anatomic pulmonary lobectomy and mediastinal lymph node dissection. Traditionally, this procedure has been carried out via a posterior lateral thoracotomy, requiring division of chest wall muscles and rib spreading. This is frequently associated with chronic postoperative pain, which may become incapacitating in 5% of patients.
One of the major potential advantages of video-assisted thoracoscopic (VATS) lobectomy is decreasing the incidence of chronic post-thoracotomy pain.
Key aspects of the procedure include the following:
- proper patient positioning;
- access to the pleural cavity and appropriate positioning of operating incisions;
- careful dissection of pulmonary arterial branches, using a “fissure-sparing” technique whenever possible to decrease the incidence of prolonged postoperative air leaks;
- division of lung parenchyma, blood vessels, and bronchus using endoscopic staplers.
The VATS approach can be performed with lower morbidity and an equivalent or better oncologic outcome to traditional open surgery. We present a VATS lobectomy for a carcinoid tumor of the left lower lobe in a 42-year-old patient. The video lays emphasis on the steps of lobe resection; mediastinal lymph node dissection was performed but is not shown.
Acknowledgment: we would like to thank Nathalie Leroux RN and Suzanne Desbiens for their continued support.
Video-assisted thoracoscopic surgery (VATS): Right middle lobectomy and complete mediastinal lymphadenectomy
The surgical management of non-small cell lung cancer (NSCLC) involves anatomical lung resection and systematic mediastinal lymph node dissection.
Video-assisted thoracic surgery (VATS) lobectomy for early NSCLC is actually preferred over a thoracotomy in experienced centers.
Potential advantages described of VATS lobectomy are decreased postoperative pain, less blood loss, shortened hospital length of stay, fewer overall complications, diminished immunologic suppression, as well as an increased ability to deliver adjuvant therapy. Oncological results are at least equivalent as thoracotomy in terms of long-term recurrence and survival rates.
We present the case of a 63-year-old woman with clinical cT2 cN0 lung adenocarcinoma of the middle lobe. The patient underwent right middle lobectomy with complete mediastinal lymph node dissection using an anterior three-port thoracoscopic approach.
M Gonzalez, T Krueger, JY Perentes
Surgical intervention
4 years ago
1750 views
41 likes
0 comments
10:42
Video-assisted thoracoscopic surgery (VATS): Right middle lobectomy and complete mediastinal lymphadenectomy
The surgical management of non-small cell lung cancer (NSCLC) involves anatomical lung resection and systematic mediastinal lymph node dissection.
Video-assisted thoracic surgery (VATS) lobectomy for early NSCLC is actually preferred over a thoracotomy in experienced centers.
Potential advantages described of VATS lobectomy are decreased postoperative pain, less blood loss, shortened hospital length of stay, fewer overall complications, diminished immunologic suppression, as well as an increased ability to deliver adjuvant therapy. Oncological results are at least equivalent as thoracotomy in terms of long-term recurrence and survival rates.
We present the case of a 63-year-old woman with clinical cT2 cN0 lung adenocarcinoma of the middle lobe. The patient underwent right middle lobectomy with complete mediastinal lymph node dissection using an anterior three-port thoracoscopic approach.
Thoracoscopic middle lobectomy with sleeve resection for bulky carcinoid tumor
We report the case of a 35-year-old female patient presenting with hemoptysis from a bulky carcinoid tumor of the middle lobe protruding in the truncus intermedius.
A middle lobectomy with sleeve resection was performed, using a full thoracoscopic approach, i.e. without utility incision. Resection margins were free. The final pathologic examination confirmed a typical pT1bN0carcinoid tumor.
The patient was discharged on postoperative day 4, after an uneventful postoperative course.
The main steps of the procedure are described. The slightly hemorrhagic atmosphere of the operation is due to vascular compression from the tumor.
D Gossot, M Grigoroiu, E Brian
Surgical intervention
5 years ago
822 views
13 likes
0 comments
09:22
Thoracoscopic middle lobectomy with sleeve resection for bulky carcinoid tumor
We report the case of a 35-year-old female patient presenting with hemoptysis from a bulky carcinoid tumor of the middle lobe protruding in the truncus intermedius.
A middle lobectomy with sleeve resection was performed, using a full thoracoscopic approach, i.e. without utility incision. Resection margins were free. The final pathologic examination confirmed a typical pT1bN0carcinoid tumor.
The patient was discharged on postoperative day 4, after an uneventful postoperative course.
The main steps of the procedure are described. The slightly hemorrhagic atmosphere of the operation is due to vascular compression from the tumor.
Video-assisted thoracoscopic (VATS) lobectomy: middle lobe
Standard treatment of early-stage non-small cell lung cancer involves anatomic pulmonary lobectomy and mediastinal lymph node dissection. Traditionally, this procedure has been carried out via a posterolateral thoracotomy, requiring division of chest wall muscles and rib spreading. This is frequently associated with chronic postoperative pain, which may become incapacitating in 5% of patients.
One of the major potential advantages of video-assisted thoracoscopic (VATS) lobectomy is decreasing the incidence of chronic post-thoracotomy pain.
Key aspects of the procedure include:
- proper patient positioning;
- access to the pleural cavity and appropriate positioning of operating incisions (Although we favor a fully thoracoscopic technique for all our cases, some centers may use a 4 to 5cm “working incision” near the axilla);
- careful dissection of pulmonary arterial branches, using a “fissure-sparing” technique whenever possible to decrease the incidence of prolonged postoperative air leaks;
- division of lung parenchyma, blood vessels, and bronchus using endoscopic staplers.
The VATS approach can be carried out with similar morbidity and similar oncologic outcome to traditional open surgery. We present VATS lobectomy for an adenocarcinoma of the middle lobe in a 67-year-old patient (the video emphasizes the steps of lobe resection - mediastinal lymph node dissection was effected but is not shown).
Acknowledgment: we would like to thank Nathalie Leroux RN and Suzanne Desbiens RN for their unfaltering dedication and continued support.
DD Masckauchan, G Rakovich
Surgical intervention
5 years ago
466 views
42 likes
0 comments
08:49
Video-assisted thoracoscopic (VATS) lobectomy: middle lobe
Standard treatment of early-stage non-small cell lung cancer involves anatomic pulmonary lobectomy and mediastinal lymph node dissection. Traditionally, this procedure has been carried out via a posterolateral thoracotomy, requiring division of chest wall muscles and rib spreading. This is frequently associated with chronic postoperative pain, which may become incapacitating in 5% of patients.
One of the major potential advantages of video-assisted thoracoscopic (VATS) lobectomy is decreasing the incidence of chronic post-thoracotomy pain.
Key aspects of the procedure include:
- proper patient positioning;
- access to the pleural cavity and appropriate positioning of operating incisions (Although we favor a fully thoracoscopic technique for all our cases, some centers may use a 4 to 5cm “working incision” near the axilla);
- careful dissection of pulmonary arterial branches, using a “fissure-sparing” technique whenever possible to decrease the incidence of prolonged postoperative air leaks;
- division of lung parenchyma, blood vessels, and bronchus using endoscopic staplers.
The VATS approach can be carried out with similar morbidity and similar oncologic outcome to traditional open surgery. We present VATS lobectomy for an adenocarcinoma of the middle lobe in a 67-year-old patient (the video emphasizes the steps of lobe resection - mediastinal lymph node dissection was effected but is not shown).
Acknowledgment: we would like to thank Nathalie Leroux RN and Suzanne Desbiens RN for their unfaltering dedication and continued support.
Robot-assisted left upper lobectomy for T1N0M0 adenocarcinoma
This is the case of a robotic left upper lobectomy with lymphadenectomy in a woman aged 52 who has had 9 children and who was a regular smoker (50 packs per year). She is presenting with an isolated cT1N0M0 adenocarcinoma in the left upper pulmonary lobe. PET-scan was positive for the lesion without any other pathological finding in the mediastinum or far metastasis. Histology was obtained by CT-guided transthoracic needle aspiration biopsy.
This minimally invasive technique, assisted by the da Vinci® robotic surgical system, is sure, comfortable, and efficient to perform a pulmonary lobectomy with lymphadenectomy in the early stages of lung cancer.
3D vision and the accuracy of dissection appear to be better than in conventional VATS.
As in VATS lobectomy, hospital stay is reduced to 3-4 days and postoperative pain appears to be more acceptable.
N Santelmo, F Antonacci, G Massard
Surgical intervention
5 years ago
536 views
6 likes
0 comments
11:59
Robot-assisted left upper lobectomy for T1N0M0 adenocarcinoma
This is the case of a robotic left upper lobectomy with lymphadenectomy in a woman aged 52 who has had 9 children and who was a regular smoker (50 packs per year). She is presenting with an isolated cT1N0M0 adenocarcinoma in the left upper pulmonary lobe. PET-scan was positive for the lesion without any other pathological finding in the mediastinum or far metastasis. Histology was obtained by CT-guided transthoracic needle aspiration biopsy.
This minimally invasive technique, assisted by the da Vinci® robotic surgical system, is sure, comfortable, and efficient to perform a pulmonary lobectomy with lymphadenectomy in the early stages of lung cancer.
3D vision and the accuracy of dissection appear to be better than in conventional VATS.
As in VATS lobectomy, hospital stay is reduced to 3-4 days and postoperative pain appears to be more acceptable.
Video-assisted thoracoscopic surgery (VATS): left upper lobectomy and complete lymphadenectomy by fissureless anterior approach
The surgical management of non-small cell lung cancer (NSCLC) involves anatomical lung resection and systematic mediastinal lymph node dissection.
Video-assisted thoracic surgery (VATS) lobectomy for early NSCLC is currently preferred over a thoracotomy in experienced centers.
Possible advantages described of VATS lobectomy are decreased postoperative pain, less blood loss, shortened hospital stay, fewer overall complications, diminished immunologic suppression, as well as an increased ability to deliver adjuvant therapy. Oncological results are at least equivalent as thoracotomy in terms of long-term recurrence and survival rates.
We present the case of a 58-year-old woman with suspicion of peripheral pulmonary cT1 cN0 cancer who initially underwent wedge resection by VATS of the lesion with preoperative localization using a CT-guided hook wire. Frozen section revealed the presence of squamous cell carcinoma, and completion lobectomy with complete mediastinal lymph node dissection was finally performed by VATS.
M Gonzalez, JY Perentes, T Krueger
Surgical intervention
5 years ago
1712 views
36 likes
0 comments
10:43
Video-assisted thoracoscopic surgery (VATS): left upper lobectomy and complete lymphadenectomy by fissureless anterior approach
The surgical management of non-small cell lung cancer (NSCLC) involves anatomical lung resection and systematic mediastinal lymph node dissection.
Video-assisted thoracic surgery (VATS) lobectomy for early NSCLC is currently preferred over a thoracotomy in experienced centers.
Possible advantages described of VATS lobectomy are decreased postoperative pain, less blood loss, shortened hospital stay, fewer overall complications, diminished immunologic suppression, as well as an increased ability to deliver adjuvant therapy. Oncological results are at least equivalent as thoracotomy in terms of long-term recurrence and survival rates.
We present the case of a 58-year-old woman with suspicion of peripheral pulmonary cT1 cN0 cancer who initially underwent wedge resection by VATS of the lesion with preoperative localization using a CT-guided hook wire. Frozen section revealed the presence of squamous cell carcinoma, and completion lobectomy with complete mediastinal lymph node dissection was finally performed by VATS.
Video-assisted thoracic surgery (VATS): middle lower bilobectomy with lymph nodes dissection for carcinoid tumor
Objective
Carcinoid tumors represent less than 5% of the bronchopulmonary cancers [1], but often concern young people. A lung-sparing anatomical resection is often preferred if possible [2]. However, an uneasy intrabronchial localization mandates a major resection such as bilobectomy and/or sometimes pneumonectomy for complete resection as it is the aim of carcinoid tumor treatment. This can be achieved using a minimally invasive approach [3, 4].
Case presentation
This is the case of a 34-year-old woman suffering from recurrent right pneumopathy, without any other medical history. A mass in the middle lobe bronchus with partial obstruction of the intermedius bronchus was found on CT-scan. Bronchoscopy found the extension of a strawberry-like tumor until segment 6 bronchus. Histopathology confirmed the presence of a carcinoid tumor. A radical excision with middle lower bilobectomy by VATS was decided upon rather than middle lobe sleeve lobectomy in order to ensure complete resection.
Results
There was no postoperative complication and the patient was discharged on postoperative day 5. The operative specimen contained the tumor. Vascular and bronchial resections were free. Histopathology confirmed a typical pT1N0 carcinoid tumor.
Conclusion
Complete middle lower bilobectomy can be performed using a VATS approach. This therapeutic option seems worthwhile in young people because of low postoperative morbidity and fast recovery for active people.

Bibliographic references
1. Fink G, Krelbaum T, Yellin A, Bendayan D, Saute M, Glazer M, Kramer MR. Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest 2001;119:1647-51.
2. Schrevens L, Vansteenkiste J, Deneffe G, De Leyn P, Verbeken E, Vandenberghe T, Demedts M. Clinical-radiological presentation and outcome of surgically treated pulmonary carcinoid tumours: a long-term single institution experience. Lung Cancer 2004;43:39-45.
3. Hansen HJ, Petersen RH, Christensen M. Video-assisted thoracoscopic surgery (VATS) lobectomy using a standardized anterior approach. Lung Cancer 2011;71,25(4):1263-9.
4. Walker WS, Codispoti M, Soon SY, Stamenkovic S, Carnochan F, Pugh G. Long-term outcomes following VATS lobectomy for non-small cell bronchogenic carcinoma. Eur J Cardiothoracic Surg 2003;23:397-402.
JM Baste, P Rinieri, A Sebestyen
Surgical intervention
5 years ago
1249 views
20 likes
0 comments
07:26
Video-assisted thoracic surgery (VATS): middle lower bilobectomy with lymph nodes dissection for carcinoid tumor
Objective
Carcinoid tumors represent less than 5% of the bronchopulmonary cancers [1], but often concern young people. A lung-sparing anatomical resection is often preferred if possible [2]. However, an uneasy intrabronchial localization mandates a major resection such as bilobectomy and/or sometimes pneumonectomy for complete resection as it is the aim of carcinoid tumor treatment. This can be achieved using a minimally invasive approach [3, 4].
Case presentation
This is the case of a 34-year-old woman suffering from recurrent right pneumopathy, without any other medical history. A mass in the middle lobe bronchus with partial obstruction of the intermedius bronchus was found on CT-scan. Bronchoscopy found the extension of a strawberry-like tumor until segment 6 bronchus. Histopathology confirmed the presence of a carcinoid tumor. A radical excision with middle lower bilobectomy by VATS was decided upon rather than middle lobe sleeve lobectomy in order to ensure complete resection.
Results
There was no postoperative complication and the patient was discharged on postoperative day 5. The operative specimen contained the tumor. Vascular and bronchial resections were free. Histopathology confirmed a typical pT1N0 carcinoid tumor.
Conclusion
Complete middle lower bilobectomy can be performed using a VATS approach. This therapeutic option seems worthwhile in young people because of low postoperative morbidity and fast recovery for active people.

Bibliographic references
1. Fink G, Krelbaum T, Yellin A, Bendayan D, Saute M, Glazer M, Kramer MR. Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest 2001;119:1647-51.
2. Schrevens L, Vansteenkiste J, Deneffe G, De Leyn P, Verbeken E, Vandenberghe T, Demedts M. Clinical-radiological presentation and outcome of surgically treated pulmonary carcinoid tumours: a long-term single institution experience. Lung Cancer 2004;43:39-45.
3. Hansen HJ, Petersen RH, Christensen M. Video-assisted thoracoscopic surgery (VATS) lobectomy using a standardized anterior approach. Lung Cancer 2011;71,25(4):1263-9.
4. Walker WS, Codispoti M, Soon SY, Stamenkovic S, Carnochan F, Pugh G. Long-term outcomes following VATS lobectomy for non-small cell bronchogenic carcinoma. Eur J Cardiothoracic Surg 2003;23:397-402.
Thoracoscopic management of empyema
From the mid-1990s, thoracoscopic treatment of empyemas has gained a wide acceptance. Potential advantages of video-assisted thoracoscopic surgery (VATS) include improved visualization, less surgical trauma and improved quality of life. VATS was initially used in early stage empyema to debride purulent collections and resect fibrin septae that failed to resolve with antibiotics and chest tube drainage (with or without fibrinolytic therapy).
The goals of the thoracoscopic treatment of empyema are as follows: 1) the debridement of purulent collections and fibrin, 2) the evacuation of necrotic material, 3) the breakdown of loculations, 4) to obtain adequate lung re-expansion, and 5) optimal chest tube placement for drainage.
Several reports have demonstrated that VATS debridement is a valid treatment option for stage II empyema, which allows an appropriate control of infection and a complete restoration of pulmonary function in early stage empyemas. Formal exclusion criteria for a primary VATS approach are suspicion of lung abscess, bronchopleural fistula, tumor at initial work-up or the need of muscle flaps with or without thoracoplasty. Presumed stage III empyema with pleural thickening and signs of restriction on CT-scan no longer are formal contraindications, but the conversion rate to decortications via thoracotomy is higher.
M Gonzalez, JY Perentes, T Krueger
Surgical intervention
5 years ago
3130 views
105 likes
0 comments
07:09
Thoracoscopic management of empyema
From the mid-1990s, thoracoscopic treatment of empyemas has gained a wide acceptance. Potential advantages of video-assisted thoracoscopic surgery (VATS) include improved visualization, less surgical trauma and improved quality of life. VATS was initially used in early stage empyema to debride purulent collections and resect fibrin septae that failed to resolve with antibiotics and chest tube drainage (with or without fibrinolytic therapy).
The goals of the thoracoscopic treatment of empyema are as follows: 1) the debridement of purulent collections and fibrin, 2) the evacuation of necrotic material, 3) the breakdown of loculations, 4) to obtain adequate lung re-expansion, and 5) optimal chest tube placement for drainage.
Several reports have demonstrated that VATS debridement is a valid treatment option for stage II empyema, which allows an appropriate control of infection and a complete restoration of pulmonary function in early stage empyemas. Formal exclusion criteria for a primary VATS approach are suspicion of lung abscess, bronchopleural fistula, tumor at initial work-up or the need of muscle flaps with or without thoracoplasty. Presumed stage III empyema with pleural thickening and signs of restriction on CT-scan no longer are formal contraindications, but the conversion rate to decortications via thoracotomy is higher.
Full endoscopic robot-assisted basal segmentectomy for bronchiectasis
Objective
Surgical treatment of bronchiectasis is often proposed in complicated situations [1]. The development of minimally invasive surgery should allow us to propose a surgical curative treatment with preventative purposes. In this video, we describe a lung-sparing surgery using a full endoscopic robotic segmentectomy as described by Dylewsky [2] to deal with localized bronchiectasis.
Case presentation
This is the case of a 40-year-old man with bronchiectasis, colonized by Pseudomonas aeruginosa with antibiotic resistance. The patient suffered from recurrent infections. Bronchiectasis is localized in the left basal segments on CT-scan. Basal segmentectomy was decided upon using a robot-assisted procedure. This kind of patient is usually treated medically with iterative antibiotherapy until a new complication occurs.
Results
There was no postoperative complication and the patient was discharged on postoperative day 4. The patient resumed work after one month without any complaint.
Conclusion
When using a precise resection, basal segmentectomy seems to be feasible using a robot-assisted procedure, without increasing perioperative morbidity. This procedure should be proposed as a preventative surgery as it is a relatively new approach for benign or infectious lung disease.
Bibliographic references
1. Agasthian T. Results of surgery for bronchiectasis and pulmonary abscesses. Thorac Surg Clin. 2012;22:333-44.
2. Dylewski MR, Ohaeto AC, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg. 2011;23:36-42.
JM Baste, P Rinieri, A Sebestyen
Surgical intervention
5 years ago
279 views
4 likes
0 comments
07:42
Full endoscopic robot-assisted basal segmentectomy for bronchiectasis
Objective
Surgical treatment of bronchiectasis is often proposed in complicated situations [1]. The development of minimally invasive surgery should allow us to propose a surgical curative treatment with preventative purposes. In this video, we describe a lung-sparing surgery using a full endoscopic robotic segmentectomy as described by Dylewsky [2] to deal with localized bronchiectasis.
Case presentation
This is the case of a 40-year-old man with bronchiectasis, colonized by Pseudomonas aeruginosa with antibiotic resistance. The patient suffered from recurrent infections. Bronchiectasis is localized in the left basal segments on CT-scan. Basal segmentectomy was decided upon using a robot-assisted procedure. This kind of patient is usually treated medically with iterative antibiotherapy until a new complication occurs.
Results
There was no postoperative complication and the patient was discharged on postoperative day 4. The patient resumed work after one month without any complaint.
Conclusion
When using a precise resection, basal segmentectomy seems to be feasible using a robot-assisted procedure, without increasing perioperative morbidity. This procedure should be proposed as a preventative surgery as it is a relatively new approach for benign or infectious lung disease.
Bibliographic references
1. Agasthian T. Results of surgery for bronchiectasis and pulmonary abscesses. Thorac Surg Clin. 2012;22:333-44.
2. Dylewski MR, Ohaeto AC, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg. 2011;23:36-42.