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Laven IEWG, Verkoulen KCHA, Franssen AJPM, Hulsewé KWE, Vissers YLJ, Štupnik T, Gonzalez-Rivas D, de Loos ER. Evolution of uniportal video-assisted thoracoscopic surgery: optimization and advancements. J Thorac Dis 2024; 16:4839-4843. [PMID: 39268107 PMCID: PMC11388257 DOI: 10.21037/jtd-24-647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/09/2024] [Indexed: 09/15/2024]
Affiliation(s)
- Iris E W G Laven
- Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Koen C H A Verkoulen
- Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Aimée J P M Franssen
- Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Karel W E Hulsewé
- Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Yvonne L J Vissers
- Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Tomaž Štupnik
- Department of Thoracic Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain
| | - Erik R de Loos
- Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
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Ng CSH. Preface on Lung Cancer Management-The Next Decade. ANNALS OF TRANSLATIONAL MEDICINE 2024; 12:41. [PMID: 38911556 PMCID: PMC11193569 DOI: 10.21037/atm-2024-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/30/2024] [Indexed: 06/25/2024]
Affiliation(s)
- Calvin S H Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
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Wang L, Cao J, Feng Y, Jia R, Ren Y. Application of uniportal video-assisted thoracoscopic surgery for segmentectomy in early-stage non-small cell lung cancer: A narrative review. Heliyon 2024; 10:e30735. [PMID: 38742067 PMCID: PMC11089358 DOI: 10.1016/j.heliyon.2024.e30735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/26/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024] Open
Abstract
Uniportal video-assisted thoracoscopic surgery (UVATS) segmentectomy has emerged as an effective approach for managing early-stage non-small-cell lung cancer (NSCLC). Compared to conventional open and thoracoscopic surgeries, this minimally invasive surgical technique offers multiple benefits, including reduced postoperative discomfort, shorter hospital stays, expedited recovery, fewer complications, and superior cosmetic outcomes. Particularly advantageous in preserving lung function, UVATS segmentectomy is a compelling option for patients with compromised lung capabilities or limited pulmonary reserve. Notably, it demonstrates promising oncological results in early-stage NSCLC, with long-term survival rates comparable to those of lobectomies. Skilled thoracic surgeons can ensure a safe and effective execution of UVATS despite the potential technical challenges posed by complex tumor locations that may hinder visibility and maneuverability within the thoracic cavity. This study provided a comprehensive review of the literature and existing studies on UVATS segmentectomies. It delves into the evolution of the technique, its current applications, and the balance between its benefits and limitations. This discussion extends the technical considerations, challenges, and prospects of UVATS segmentectomy. Furthermore, it aimed to update advancements in segmentectomy for treating early-stage NSCLC, offering in-depth insights to thoracic surgeons to inform more scientifically grounded and patient-specific surgical decisions.
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Affiliation(s)
- Linlin Wang
- Department of Thoracic Surgery, Shenyang Tenth People's Hospital, Shenyang, Liaoning, China
| | - Jiandong Cao
- Department of Thoracic Surgery, Shenyang Tenth People's Hospital, Shenyang, Liaoning, China
| | - Yong Feng
- Department of Thoracic Surgery, Shenyang Tenth People's Hospital, Shenyang, Liaoning, China
| | - Renxiang Jia
- Department of Thoracic Surgery, Shenyang Tenth People's Hospital, Shenyang, Liaoning, China
| | - Yi Ren
- Department of Thoracic Surgery, Shenyang Tenth People's Hospital, Shenyang, Liaoning, China
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Paglialunga PL, Molins L, Guzmán R, Guirao A, Grando L, Sanchez-Lorente D, Guerrero C, Bello I, Quiroga N, Boada M. Starting a robotic thoracic surgery program: From wedge resection to sleeve lobectomy in six months. Initial conclusions. Cir Esp 2023; 101:833-840. [PMID: 37544607 DOI: 10.1016/j.cireng.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/08/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Robot-assisted thoracic surgery (RATS) is a rapidly expanding technique. In our study, we aimed to analyze the results of the process to adopt robotic surgery in our Department of Thoracic Surgery. METHODS This is an intention-to-treat analysis of a series of consecutive patients operated on using the RATS approach in our hospital from January 2021 to March 2022. Data were registered for patient characteristics, type of surgery, operative times, conversion rate, chest tube duration, length of hospital stay and complications. The IBM SPSS® statistical software was used for the statistical analysis. A cumulative sum analysis of the operating time was performed to define the learning curve. RESULTS During the study period, 51 patients underwent robotic surgery, including pulmonary and non-pulmonary interventions. In addition, 15 patients (29.4%) underwent non-pulmonary interventions: one pleural (2%), 2 diaphragmatic (3.9%), and 12 mediastinal (23.5%). Among the mediastinal surgeries, one conversion was necessary (8.3%) for a complex vascular malformation, and 11 were completed by RATS, including 7 (58.3%) thymomas, 3 (25%) pleuro-pericardial cysts, and one (8.3%) neurogenic tumor. Mean operative time was 141 min (104-178), mean chest tube duration was 0.9 days (0-2), and mean length of stay was 1.45 days (1-2). Thirty-six patients underwent lung surgery (70.6%). The complete RATS resections (34; 94.4%) included: 3 wedge resections (11.1%), 2 segmentectomies (3.7%), 28 lobectomies (81.5%), and one sleeve lobectomy (3.7%). Mean surgery time was 194.56 min (141-247), chest tube duration was 3.92 days (1-8), and length of stay was 4.6 days (1-8). Complications occurred in 4 patients (11.1%). No 90-day mortalities were registered. CONCLUSIONS The implementation of RATS was achieved with good clinical results and operative times for all indications. A rapid learning curve was accomplished in short time. Previous VATS experience, patient selection, team training and program continuity are fundamental to successfully develop a RATS program.
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Affiliation(s)
- Pablo Luis Paglialunga
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Laureano Molins
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Rudith Guzmán
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Angela Guirao
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Leandro Grando
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - David Sanchez-Lorente
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carlos Guerrero
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Irene Bello
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Nestor Quiroga
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - Marc Boada
- Department of Thoracic Surgery, Institut Clínic Respiratori (ICR), Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
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Manolache V, Motas N, Bosinceanu ML, de la Torre M, Gallego-Poveda J, Dunning J, Ismail M, Turna A, Paradela M, Decker G, Ramos R, Bodner J, Espinosa Jimenez D, Zardo P, Garcia-Perez A, Ureña Lluveras A, Pantile D, Gonzalez-Rivas D. Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience. Ann Cardiothorac Surg 2023; 12:102-109. [PMID: 37035654 PMCID: PMC10080339 DOI: 10.21037/acs-2022-urats-27] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/17/2023] [Indexed: 03/12/2023]
Abstract
Background Robotic-assisted thoracic surgery (RATS) has seen increasing interest in the last few years, with most procedures primarily being performed in the conventional multiport manner. Our team has developed a new approach that has the potential to convert surgeons from uniportal video-assisted thoracic surgery (VATS) or open surgery to robotic-assisted surgery, uniportal-RATS (U-RATS). We aimed to evaluate the outcomes of one single incision, uniportal robotic-assisted thoracic surgery (U-RATS) against standard multiport RATS (M-RATS) with regards to safety, feasibility, surgical technique, immediate oncological result, postoperative recovery, and 30-day follow-up morbidity and mortality. Methods We performed a large retrospective multi-institutional review of our prospectively curated database, including 101 consecutive U-RATS procedures performed from September 2021 to October 2022, in the European centers that our main surgeon operates in. We compared these cases to 101 consecutive M-RATS cases done by our colleagues in Barcelona between 2019 to 2022. Results Both patient groups were similar with respect to demographics, smoking status and tumor size, but were significantly younger in the U-RATS group [M-RATS =69 (range, 39-81) years; U-RATS =63 years (range, 19-82) years; P<0.0001]. Most patients in both operative groups underwent resection of a primary non-small cell lung cancer (NSCLC) [M-RATS 96/101 (95%); U-RATS =60/101 (59%); P<0.0001]. The main type of anatomic resection was lobectomy for the multiport group, and segmentectomy for the U-RATS group. In the M-RATS group, only one anatomical segmentectomy was performed, while the U-RATS group had twenty-four (24%) segmentectomies (P=0.0006). All M-RATS and U-RATS surgical specimens had negative resection margins (R0) and contained an equivalent median number of lymph nodes available for pathologic analysis [M-RATS =11 (range, 5-54); U-RATS =15 (range, 0-41); P=0.87]. Conversion rate to thoracotomy was zero in the U-RATS group and low in M-RATS [M-RATS =2/101 (2%); U-RATS =0/101; P=0.19]. Median operative time was also statistically different [M-RATS =150 (range, 60-300) minutes; U-RATS =136 (range, 30-308) minutes; P=0.0001]. Median length of stay was significantly lower in U-RATS group at four days [M-RATS =5 (range, 2-31) days; U-RATS =4 (range, 1-18) days; P<0.0001]. Rate of complications and 30-day mortality was low in both groups. Conclusions U-RATS is feasible and safe for anatomic lung resections and comparable to the multiport conventional approach regarding surgical outcomes. Given the similarity of the technique to uniportal VATS, it presents the potential to convert minimally invasive thoracic surgeons to a robotic-assisted approach.
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Affiliation(s)
- Veronica Manolache
- Department of Thoracic Surgery, Memorial Oncology Hospital, Bucharest, Romania
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Natalia Motas
- Department of Thoracic Surgery, Memorial Oncology Hospital, Bucharest, Romania
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Department of Thoracic Surgery, Institute of Oncology “Prof. Dr. Al. Trestioreanu”, Bucharest, Romania
| | | | | | | | - Joel Dunning
- Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann Potsdam, Academic Hospital of the Charité-Universitätsmedizin Humboldt University Berlin, Potsdam, Germany
| | - Akif Turna
- Department of Thoracic Surgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul, Turkey
| | - Marina Paradela
- Department of Thoracic Surgery, Coruña University Hospital, A Coruña, Spain
| | - Georges Decker
- Department of Thoracic Surgery, Hôpitaux Robert Schuman-ZithaKlinik, Luxembourg, Luxembourg
| | - Ricard Ramos
- Thoracic Surgery Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Johanes Bodner
- Department of Thoracic Surgery, Klinikum Bogenhausen, Englschalkinger Strasse 77, Munchen, Germany
| | | | - Patrick Zardo
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | | | - Anna Ureña Lluveras
- Thoracic Surgery Service, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Daniel Pantile
- Department of Thoracic Surgery, Central Military Emergency University Hospital Bucharest, Bucharest, Romania
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery, Memorial Oncology Hospital, Bucharest, Romania
- Department of Thoracic Surgery, Coruña University Hospital, A Coruña, Spain
- Department of Cardio-Thoracic Surgery, Lusiadas Hospital, Lisbon, Portugal
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann Potsdam, Academic Hospital of the Charité-Universitätsmedizin Humboldt University Berlin, Potsdam, Germany
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Manolache V, Gonzalez-Rivas D, Bosinceanu ML, Gallego-Poveda J, Garcia-Perez A, Motas N. Uniportal robotic-assisted thoracic surgery for mediastinal tumors. Ann Cardiothorac Surg 2023; 12:139-141. [PMID: 37035645 PMCID: PMC10080335 DOI: 10.21037/acs-2022-urats-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/11/2022] [Indexed: 01/01/2023]
Affiliation(s)
- Veronica Manolache
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain
| | - Mugurel Liviu Bosinceanu
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
| | | | | | - Natalia Motas
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Department of Thoracic Surgery, Institute of Oncology “Prof. Dr. Al. Trestioreanu”, Bucharest, Romania
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Motas N, Manolache V, Bosinceanu ML, Bale M, Decker G, Gonzalez-Rivas D. Uniportal robotic-assisted thoracic surgery anatomic segmentectomies. Ann Cardiothorac Surg 2023; 12:133-135. [PMID: 37035640 PMCID: PMC10080338 DOI: 10.21037/acs-2022-urats-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Natalia Motas
- University of Medicine and Pharmacy Carol Davila, Bulevardul Eroii Sanitari 8, Bucharest, Romania
- Department of Thoracic Surgery, Institute of Oncology Prof. Dr. Al. Trestioreanu, Șoseaua Fundeni 252, Bucharest, Romania
- Department of Thoracic Surgery, Memorial Oncology Hospital, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
| | - Veronica Manolache
- University of Medicine and Pharmacy Carol Davila, Bulevardul Eroii Sanitari 8, Bucharest, Romania
- Department of Thoracic Surgery, Memorial Oncology Hospital, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
| | - Mugurel Liviu Bosinceanu
- Department of Thoracic Surgery, Memorial Oncology Hospital, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
| | - Manjunath Bale
- Thoracic Surgery, Apollo Health City, Film Nagar, Jubilee Hills, Hyderabad, Telangana, India
| | - George Decker
- Thoracic Surgery, Hôpitaux Robert Schuman-ZithaKlinik, Luxembourg, Luxembourg
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery, Memorial Oncology Hospital, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain
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Sihoe ADL. Transition from multiportal video-assisted thoracic surgery to uniportal video-assisted thoracic surgery… and evolution to uniportal robotic-assisted thoracic surgery? Ann Cardiothorac Surg 2023; 12:82-90. [PMID: 37035650 PMCID: PMC10080341 DOI: 10.21037/acs-2022-urats-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/15/2022] [Indexed: 01/01/2023]
Abstract
The greatest disruptive innovation in lung cancer surgery in modern times has been the switch from open thoracotomy to video-assisted thoracic surgery (VATS). More recently, the transition from multiportal VATS (MVATS) to uniportal VATS (UVATS) has represented another mini-advance in reducing surgical access trauma. In the search for the next breakthrough in lung cancer surgery, a number of promising candidates have emerged, including screening, sublobar resections, 3D technology, enhanced peri-operative care pathways, ablative therapy and multi-modality management. However, could the way forwards be simply a further minimization of surgical access trauma, and could this be achieved by uniportal robotic surgery? Emergence of a 'winning' candidate will depend on a systematic evaluation of the evidence for the benefits and costs of each.
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Affiliation(s)
- Alan D. L. Sihoe
- Consultant in Cardio-Thoracic Surgery, CUHK Medical Centre, Hong Kong, China
- Honorary Consultant in Cardio-Thoracic Surgery, Gleneagles Hong Kong Hospital, Hong Kong, China
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Gonzalez-Rivas D, Prado RF, Garcia-Perez A, Bosinceanu ML, Motas N, Manolache V. Bilateral uniportal robotic-assisted thoracic surgery sleeve lobectomy for a bilateral endobronchial lung cancer. Ann Cardiothorac Surg 2023; 12:64-66. [PMID: 36793983 PMCID: PMC9922774 DOI: 10.21037/acs-2022-urats-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Diego Gonzalez-Rivas
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
| | - Ricardo Fernandez Prado
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain
| | | | - Mugurel Liviu Bosinceanu
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
| | - Natalia Motas
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
- University of Medicine and Pharmacy “Carol Davila”, Bulevardul Eroii Sanitari 8, Bucharest, Romania
- Department of Thoracic Surgery, Institute of Oncology “Prof. Dr. Al. Trestioreanu”, Bucharest, Romania
| | - Veronica Manolache
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Șoseaua Gheorghe Ionescu Sisești 8a, Bucharest, Romania
- University of Medicine and Pharmacy “Carol Davila”, Bulevardul Eroii Sanitari 8, Bucharest, Romania
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Motas N, Gonzalez-Rivas D, Bosinceanu ML, Gallego-Poveda J, Garcia-Perez A, Manolache V. Uniportal robotic-assisted thoracic surgery pneumonectomy. Ann Cardiothorac Surg 2023; 12:67-69. [PMID: 36793985 PMCID: PMC9922768 DOI: 10.21037/acs-2022-urats-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/11/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Natalia Motas
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Department of Thoracic Surgery, Institute of Oncology “Prof. Dr. Al. Trestioreanu”, Bucharest, Romania
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
- Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, A Coruña, Spain
| | - Mugurel Liviu Bosinceanu
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
| | | | | | - Veronica Manolache
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Department of Thoracic Surgery, Policlinico di Monza, Oncology Hospital Monza, Bucharest, Romania
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Mercadante E, Martucci N, De Luca G, La Rocca A, La Manna C. Early experience with uniportal robotic thoracic surgery lobectomy. Front Surg 2022; 9:1005860. [PMID: 36329983 PMCID: PMC9624124 DOI: 10.3389/fsurg.2022.1005860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Invasiveness is considered one of the cornerstones of every field of surgery, and video-assisted thoracoscopic (VATS) approaches are now routinely used worldwide to perform pulmonary resections. Recently, robotic-assisted thoracic surgery (RATS) has become the preferred technique in many centers; it is routinely performed using three or four ports with at least one service incision, contrasting with the real concept of invasiveness, especially when compared to uniportal VATS (U-VATS). Hereby, we present our early experience with uniportal RATS (U-RATS) pulmonary resections for early-stage lung cancer. Technical details of surgical steps are accurately described and commented on. Results Twenty-four consecutive patients with lung cancer underwent U-RATS anatomical pulmonary resections at our institute. All procedures were completed with the uniportal approach. The mean operative time was 210 min (range 120-350); in the last 10 cases, the operative time was significantly reduced (180 min) compared to the first 10 cases (232 min) (p < 0.02), showing a very fast learning curve. The postoperative pain score was comparable to that for U-VATS and was constantly low. Conclusions U-RATS is a safe and feasible technique, combining the advantages of U-VATS with the well-known advantages of robotic surgery.
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Affiliation(s)
- Edoardo Mercadante
- Thoracic Surgery Unit - Istituto Nazionale Tumori – IRCCS – Fondazione G. Pascale, Naples, Italy
| | - Nicola Martucci
- Thoracic Surgery Unit - Istituto Nazionale Tumori – IRCCS – Fondazione G. Pascale, Naples, Italy
| | - Giuseppe De Luca
- Thoracic Surgery Unit - Istituto Nazionale Tumori – IRCCS – Fondazione G. Pascale, Naples, Italy
| | - Antonello La Rocca
- Thoracic Surgery Unit - Istituto Nazionale Tumori – IRCCS – Fondazione G. Pascale, Naples, Italy
| | - Carmine La Manna
- Thoracic Surgery Unit - Istituto Nazionale Tumori – IRCCS – Fondazione G. Pascale, Naples, Italy
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