Early Operative Experience and Preliminary Clinical Results

Summary: Background: Robotic surgery represents the most advanced development of minimally invasive surgery. We are currently using a robotic system to test the applicability of this technique to standard and advanced thoracic procedures. We report our experience in five patients in whom a video robotic lobectomy (VRL) was attempted. Methods: All patients had peripheral pulmonary opacities: three of these were bronchogenic carcinoma (stage I), two were typical carcinoid lesions. Surgical access was gained via two stab incisions and one short lateral incision, which was made for specimen delivery and was used without rib separation. Results: There were no major intra-operative complications and all patients recovered uneventfully. Two procedures that began with the robotic technique were completed by a minimal thoracotomy. In each case no technical operative mishaps were caused by the manoeuvres of robotic arms. Conclusions: VRL is technically possible. This preliminary study supports the development of robotic surgery in the field of thoracic surgery. Our experience also indicates that considerable improvements are necessary to allow major procedures such as pulmonary lobectomy to be safely and expeditiously performed using the robotic approach.