10.25373/ctsnet.6121967.v1
Marco Nardini
Marco
Nardini
Joel Dunning
Joel
Dunning
Marcello Migliore
Marcello
Migliore
Robert J. Cerfolio
Robert J.
Cerfolio
Right Main Bronchus Sleeve Resection
CTSNet
2018
Thoracic
Lung Cancer
Robotic Thoracic Surgery
Minimally Invasive Surgery
Surgery
2018-04-30 18:43:24
Media
https://ctsnet.figshare.com/articles/media/Right_Main_Bronchus_Sleeve_Resection/6121967
<p><strong>Introduction</strong><br>Carcinoid is a rare lung cancer that originates from the neuroendocrine cells of the airways. Pulmonary parenchyma sparing procedures should be attempted whenever feasible. Bronchoplasty and sleeve resection are technically challenging, and a minimally invasive approach has been attempted in only a few dedicated centers.<br><strong>Video Description</strong><br>Professor Cerfolio demonstrates the adoption of a four-arm robotic technique to resect a carcinoid tumor, which originated from the right main bronchus. The ports' positions are shown. The bronchus is isolated, and it is incised proximal to the lesion. The mass, which was occluding the right main bronchus, is excised and sent for frozen sectioning to ensure the margins’ clearance. The bronchus is dissected free from the artery. The bronchus is then completely divided and the edges are trimmed to suit the anastomosis of the proximal and distal stumps. This is achieved with two continuous 3-0 barbed sutures. Finally, the results are checked by flexible bronchoscopy, and one apical chest drain is placed.<br><strong>Conclusion</strong><br>The authors suggest that the robot, in view of the instrument articulation, is the ideal minimally invasive platform to perform reconstruction of the airways. Such a procedure would otherwise be performed through open surgery.</p><p>Dr Cerfolio lectures for Intuitive Surgical. <br></p>