Feasibility and quality control of robotic sleeve lobectomy and bronchoplasty_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Xilong , XU Shiguang , LIU Bo , WU Ziheng , LIU Deyu , XU Wei , WANG Bin , DING Renquan , LIU Xingchi ,  WANG Shumin

Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, 110016, P.R.China;

Corresponding?author：

WANG Shumin, Email: sureman2003congo@163.com

Keywords：

Bronchoplasty; sleeve lobectomy; minimally invasive; robotic

DOI：

10.7507/1007-4848.201910056

Video：

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Objective To explore the feasibility of robotic sleeve lobectomy and bronchoplasty and to summarize the experience of quality control and technical process management.Methods From January to December 2018, our hospital completed robotic sleeve lobectomy and bronchoplasty for 5 patients, including the upper right lung lobe in 2 patients, the middle right lung lobe in 1 patient and the lower left lung lobe in 2 patients. There were 3 males and 2 females with an age of 56.6 (39-75) years. The surgical approach was the same as the surgical incision of the robotic lobectomy. During the operation, the lobes were separated, all enlarged mediastinal lymph nodes were cleaned, pulmonary hilum was dissected, pulmonary arteriovenous vessels and bronchi were exposed, and pulmonary vessels were treated. After exposing the main bronchi, the bronchi were cut off at the distal end of the lesion, and the lobes where the lesion was located (including lesions) were excised by sleeve type and the bronchi were continuously sutured with 3-0 Prolene from the back wall for anastomosis. After the anastomosis, no air leakage was found in the expanded lung, and the anastomosis was no longer wrapped.Results The operation time was 147.4 (100-192) min, including bronchial anastomosis time 17.6 (14-25) min. Intraoperative blood loss was 60.0 (20-100) mL, and 20 (9-37) lymph nodes were dissected. Three patients had squamous cell carcinoma, 1 adenocarcinoma, and 1 neuroendocrine tumor. All patients showed negative results in the freezing pathology of bronchial stump during operation. All patients recovered well after surgery, without perioperative complications, and the anastomosis was smooth. Postoperative hospital stay was 10.8 (7-14) days. The patients were followed up for 6 to 12 months without anastomotic stenosis or other complications.Conclusion Since the robot system is a special instrument with 3D vision and 7 degrees of freedom for movable joints, the robotic bronchial suture is more flexible and accurate. The robotic sleeve lobectomy and bronchoplasty are safe and feasible.

Citation： WANG Xilong, XU Shiguang, LIU Bo, WU Ziheng, LIU Deyu, XU Wei, WANG Bin, DING Renquan, LIU Xingchi, WANG Shumin. Feasibility and quality control of robotic sleeve lobectomy and bronchoplasty. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(2): 190-194. doi: 10.7507/1007-4848.201910056 Copy

1.	嵇武, 李寧, 黎介壽. 我國手術機器人外科面臨的機遇和挑戰. 中國微創外科雜志, 2012, 12(7): 577-579.
2.	王述民, 許世廣, 童向東, 等. 機器人肺葉切除術治療非小細胞肺癌. 中國胸心血管外科臨床雜志, 2013, 20(3): 308-311.
3.	王述民, 童向東, 劉博, 等. 達芬奇機器人左肺上葉切除術和淋巴結清除術治療非小細胞肺癌. 中國胸心血管外科臨床雜志, 2015, 22(3): 215-219.
4.	Velez-Cubian FO, Rodriguez KL, Thau MR, et al. Efficacy of lymph node dissection during robotic-assisted lobectomy for non-small cell lung cancer: retrospective review of 159 consecutive cases. J Thorac Dis, 2016, 8(9): 2454-2463.
5.	張大坤, 許世廣, 丁仁泉, 等. 達芬奇機器人手術與胸腔鏡輔助小切口手術對肺手術患者創傷對比分析. 創傷與急危重病醫學, 2014, 2(5): 296-300.
6.	王述民. 達芬奇機器人在肺癌根治術中的應用現狀及展望. 中國腫瘤, 2014, 23(9): 736-742.
7.	Louie BE, Farivar AS, Aye RW, et al. Early experience with robotic lung resection results in similar operative outcomes and morbidity when compared with matched video-assisted thoracoscopic surgery cases. Ann Thorac Surg, 2012, 93(5): 1598-1604.
8.	許世廣, 劉星池, 王希龍, 等. 應用達芬奇機器人手術系統肺切除技術總結. 中華胸部外科電子雜志, 2016, 3(2): 77-82.
9.	Tronc F, Gregoire J, Deslauriers J. Bronchoplasty. In: Patterson G, Cooper J, Deslauriers J, et al, eds. Pearson’s Thoracic & Esophageal Surgery. 3rd ed. Phila-delphia, PA: Churchill Livingstone Elsevier, 2008. 894–908.
10.	Santambrogio L, Cioffi U, De Simone M, et al. Video-assisted sleeve lobectomy for mucoepidermoid carcinoma of the left lower lobar bronchus: a case report. Chest, 2002, 121(2): 635-636.
11.	Mahtabifard A, Fuller CB, McKenna RJ Jr. Video-assisted thoracic surgery sleeve lobectomy: a case series. Ann Thorac Surg, 2008, 85(2): S729-S732.
12.	劉倫旭, 梅建東, 蒲強, 等. 全胸腔鏡支氣管袖式成形肺癌切除的初步探討. 中國胸心血管外科臨床雜志, 2011, 18(5): 387-389.
13.	劉鴻程, 朱余明, 姜格寧, 等. 全胸腔鏡右肺上葉切除支氣管袖式成形2例. 中華胸心血管外科雜志, 2011, 27(10): 618.
14.	Gu C, Pan X, Chen Y, et al. Short-term and mid-term survival in bronchial sleeve resection by robotic system versus thoracotomy for centrally located lung cancer. Eur J Cardiothorac Surg, 2018, 53(3): 648-655.
15.	Cerfolio RJ. Robotic sleeve lobectomy: technical details and early results. J Thorac Dis, 2016, 8(Suppl 2): S223-S226.
16.	Ishikawa N, Sun YS, Nifong LW, et al. Thoracoscopic robot-assisted bronchoplasty. Surg Endosc, 2006, 20(11): 1782-1783.
17.	Schmid T, Augustin F, Kainz G, et al. Hybrid video-assisted thoracic surgery-robotic minimally invasive right upper lobe sleeve lobectomy. Ann Thorac Surg, 2011, 91(6): 1961-1965.
18.	王希龍, 許世廣, 劉博, 等. 達芬奇機器人與胸腔鏡輔助小切口手術患者術后疼痛的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(3): 230-233.
19.	許世廣, 王希龍, 童向東, 等. 機器人與電視胸腔鏡手術治療縱隔支氣管源性囊腫的對比研究. 中國微創外科雜志, 2015, 15(3): 193-196.
20.	梅建東, 蒲強, 馬林, 等. 全胸腔鏡支氣管袖式成形肺癌切除的流程設計與優化. 四川大學學報(醫學版), 2013, 44(1): 114-118.
21.	Nakanishi R, Yamashita T, Oka S. Initial experience of video-assisted thoracic surgery lobectomy with partial removal of the pulmonary artery. Interact Cardiovasc Thorac Surg, 2008, 7(6): 996-1000.
22.	Li Y, Wang J. Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty: an improved operative technique. Eur J Cardiothorac Surg, 2013, 44(6): 1108-1112.
23.	李運, 李劍鋒, 王俊. 全腔鏡支氣管袖式切除術. 中華胸心血管外科雜志, 2012, 28(9): 513-515.
24.	蔣偉, 奚俊杰, 王群, 等. 全胸腔鏡肺癌根治術淋巴結清掃的探討. 中國微創外科雜志, 2012, 12(11): 969-972, 975.

1. 嵇武, 李寧, 黎介壽. 我國手術機器人外科面臨的機遇和挑戰. 中國微創外科雜志, 2012, 12(7): 577-579.
2. 王述民, 許世廣, 童向東, 等. 機器人肺葉切除術治療非小細胞肺癌. 中國胸心血管外科臨床雜志, 2013, 20(3): 308-311.
3. 王述民, 童向東, 劉博, 等. 達芬奇機器人左肺上葉切除術和淋巴結清除術治療非小細胞肺癌. 中國胸心血管外科臨床雜志, 2015, 22(3): 215-219.
4. Velez-Cubian FO, Rodriguez KL, Thau MR, et al. Efficacy of lymph node dissection during robotic-assisted lobectomy for non-small cell lung cancer: retrospective review of 159 consecutive cases. J Thorac Dis, 2016, 8(9): 2454-2463.
5. 張大坤, 許世廣, 丁仁泉, 等. 達芬奇機器人手術與胸腔鏡輔助小切口手術對肺手術患者創傷對比分析. 創傷與急危重病醫學, 2014, 2(5): 296-300.
6. 王述民. 達芬奇機器人在肺癌根治術中的應用現狀及展望. 中國腫瘤, 2014, 23(9): 736-742.
7. Louie BE, Farivar AS, Aye RW, et al. Early experience with robotic lung resection results in similar operative outcomes and morbidity when compared with matched video-assisted thoracoscopic surgery cases. Ann Thorac Surg, 2012, 93(5): 1598-1604.
8. 許世廣, 劉星池, 王希龍, 等. 應用達芬奇機器人手術系統肺切除技術總結. 中華胸部外科電子雜志, 2016, 3(2): 77-82.
9. Tronc F, Gregoire J, Deslauriers J. Bronchoplasty. In: Patterson G, Cooper J, Deslauriers J, et al, eds. Pearson’s Thoracic & Esophageal Surgery. 3rd ed. Phila-delphia, PA: Churchill Livingstone Elsevier, 2008. 894–908.
10. Santambrogio L, Cioffi U, De Simone M, et al. Video-assisted sleeve lobectomy for mucoepidermoid carcinoma of the left lower lobar bronchus: a case report. Chest, 2002, 121(2): 635-636.
11. Mahtabifard A, Fuller CB, McKenna RJ Jr. Video-assisted thoracic surgery sleeve lobectomy: a case series. Ann Thorac Surg, 2008, 85(2): S729-S732.
12. 劉倫旭, 梅建東, 蒲強, 等. 全胸腔鏡支氣管袖式成形肺癌切除的初步探討. 中國胸心血管外科臨床雜志, 2011, 18(5): 387-389.
13. 劉鴻程, 朱余明, 姜格寧, 等. 全胸腔鏡右肺上葉切除支氣管袖式成形2例. 中華胸心血管外科雜志, 2011, 27(10): 618.
14. Gu C, Pan X, Chen Y, et al. Short-term and mid-term survival in bronchial sleeve resection by robotic system versus thoracotomy for centrally located lung cancer. Eur J Cardiothorac Surg, 2018, 53(3): 648-655.
15. Cerfolio RJ. Robotic sleeve lobectomy: technical details and early results. J Thorac Dis, 2016, 8(Suppl 2): S223-S226.
16. Ishikawa N, Sun YS, Nifong LW, et al. Thoracoscopic robot-assisted bronchoplasty. Surg Endosc, 2006, 20(11): 1782-1783.
17. Schmid T, Augustin F, Kainz G, et al. Hybrid video-assisted thoracic surgery-robotic minimally invasive right upper lobe sleeve lobectomy. Ann Thorac Surg, 2011, 91(6): 1961-1965.
18. 王希龍, 許世廣, 劉博, 等. 達芬奇機器人與胸腔鏡輔助小切口手術患者術后疼痛的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(3): 230-233.
19. 許世廣, 王希龍, 童向東, 等. 機器人與電視胸腔鏡手術治療縱隔支氣管源性囊腫的對比研究. 中國微創外科雜志, 2015, 15(3): 193-196.
20. 梅建東, 蒲強, 馬林, 等. 全胸腔鏡支氣管袖式成形肺癌切除的流程設計與優化. 四川大學學報(醫學版), 2013, 44(1): 114-118.
21. Nakanishi R, Yamashita T, Oka S. Initial experience of video-assisted thoracic surgery lobectomy with partial removal of the pulmonary artery. Interact Cardiovasc Thorac Surg, 2008, 7(6): 996-1000.
22. Li Y, Wang J. Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty: an improved operative technique. Eur J Cardiothorac Surg, 2013, 44(6): 1108-1112.
23. 李運, 李劍鋒, 王俊. 全腔鏡支氣管袖式切除術. 中華胸心血管外科雜志, 2012, 28(9): 513-515.
24. 蔣偉, 奚俊杰, 王群, 等. 全胸腔鏡肺癌根治術淋巴結清掃的探討. 中國微創外科雜志, 2012, 12(11): 969-972, 975.

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Feasibility and quality control of robotic sleeve lobectomy and bronchoplasty

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