Robotic thoracic surgery has slowly gained acceptance over the past 4 years. While a wide variety of case are able to be performed robotically, the advantages for each procedure has been questioned. The purpose of our review is to identify the lessons learned from our experience as we move forward to the future.
A retrospective review of our prospective database was performed from Jan 2002 until May 2005. All thoracic robotic procedures were included. The robotic system used for all cases was the da Vinci Surgical System.
A total of 35 cases have been performed encompassing all areas of general thoracic surgery. No complications related to the robot occurred. One conversion occurred secondary to bleeding, which did not require a transfusion. Length of stay for each procedure was short as compared to open procedures for most procedures including: thymectomy, mediastinal mass resection and Heller myotomy.
Robotic thoracic procedures can be safely performed using the current robotic system. For various procedures including thymectomy /anterior mediastinal mass resections, Heller myotomy and brachytherapy, robotic assistance appears to offer advantages over open procedures at our institution. Necessary components that are needed to build a successful robotic program including dedicated OR personnel and a dedicated surgical team. Learning curves are yet to be defined; however they appear to be shorter as compared to standard laparoscopic and thoracoscopic procedures.
The future of robotic cardiothoracic surgery is dependent upon measuring objective outcomes in comparison to other minimally invasive procedures rather than open procedures. Learning curves and teaching protocols need to be defined and developed to ensure the continued growth and safety of robotic surgery.
ProcedureCasesConversionEsophageal resection110Thymectomy90Heller myotomy60Mediastinal mass resection/biopsy51Brachytherapy30Lobectomy10
Robert Ashton, Consultant fee, speaker bureau, advisory committee, etc. Procotor for cases by members of the department.