Initial Experience of Robot-assisted Surgery for 47 Patients with Mediastinal Tumor_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LINHao , HUANGJia ,  LUOQing-quan

Shanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai 200030, P. R. China;

Corresponding author：

LUOQing-quan, Email: luoqingquan@hotmail.com

Keywords：

Robotic surgery; Mediastinal tumor resection; Minimally invasive thoracic surgery

DOI：

10.7507/1007-4848.20150229

Video：

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Objectives To investigate the safety and efficacy of robot-assisted surgery for mediastinal tumor. Methods We respectively analyzed the clinical data of 47 patients with clinical diagnosis of mediastinal tumor undergoing robot-assisted surgery in our hospital from May 2009 to March 2015. There were 29 males and 18 females at age of 48 (20-78) years. Robotic instruments were used through two 8 mm thoracoscopic ports and camera placed through a 12 mm observation port, without any additional utility incision. Results All 47 surgeries were accomplished successfully. The operative time was 73±36 minutes. The blood loss was 48±15 ml. There was only one conversion due to bleeding during the operation. No perioperative mortality or morbidity occurred. There was no perioperative transfusion. Learning curve showed operative time shortened sharply as the procedures increased. After 20 cases of procedure, operative time was stabilized as the learning curve established. The equation is y(min)=-20.41ln(x)+119.43, R²=0.312, P<0.01. Conclusion Robot-assisted surgery for mediastinal tumor are initially proved safe and feasible with great perspective in the new age of minimally invasive thoracic surgery.

Citation： LINHao, HUANGJia, LUOQing-quan. Initial Experience of Robot-assisted Surgery for 47 Patients with Mediastinal Tumor. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(10): 914-918. doi: 10.7507/1007-4848.20150229 Copy

1.	Nagahiro I,Andou A,Aoe M,et al.Pulmonary function,postoperative pain,and serum cytokine level after lobectomy:a comparison of VATS and conventional procedure.Ann Thorac Surg,2001,72(2):362-365.
2.	Forster R,Storck M,Schafer JR,et al.Thoracoscopy versus thoracotomy:a prospective comparison of trauma and quality of life.Langenbecks Arch Surg,2002,387(1):32-36.
3.	Dieter RA Jr,Kuzycz GB.Complications and contraindications of thoracoscopy.Int Surg,1997,82(3):232-239.
4.	Augustin F,Bodner J,Wykypiel H,et al.Initial experience with robotic lung lobectomy:report of two different approaches.Surg Endosc,2011,25(1):108-113.
5.	黄佳,罗清泉,谭强.机器人外科手术系统辅助胸腔镜胸腺瘤切除手术一例.上海医学,2010,33(11):1072.
6.	Maat AP,Van Doorn PA,Bogers AJ.Inclusion of the transcervical approach in the video-assisted thoracoscopic extended thymectomy(BATET)for myasthenia gravis:a prospective trial.Surg Endosc,2008,22(1):265.
7.	Weksler B,Tavares J,Newhook TE,et al.Robot-assisted thymectomy is superior to transsternal thymectomy.Surg Endosc,2012,26:261-266.
8.	Yim AP.Thoracoscopic thymectomy:which side to approach?Ann Thorac Surg,1997,64(2):584-585.
9.	Mack MJ.Video-assisted thoracoscopy thymectomy for myasthenia gravis.Chest Surg Clin N Am,2001,11(2):389-405.
10.	Goldstein SD,Yang SC.Assessment of robotic thymectomy using the Myasthenia Gravis Foundation of America Guidelines.Ann Thorac Surg,2011,89:1080-1085.
11.	Ruckert JC,Ismail M,Swierzy M,et al.Thoracoscopic thymectomy with the da Vinci robotic system for myasthenia gravis.Ann NY Acad Sci,2008,1132:329-335.
12.	Ruckert JC,Swierzy M,Ismail M.Comparison of robotic and nonrobotic thoracoscopic thymectomy:a cohort study.J Thorac Cardiovasc Surg,2011,141:673-677.
13.	Bodner J,Wykypiel H,Greiner A,et al.Early experience with robot-assisted surgery for mediastinal masses.Ann Thorac Surg,2004,78:259-265.
14.	Bodner J,Wykypiel H,Wetscher G,et al.First experiences with the da Vinci operating robot in thoracic surgery.Eur J Cardiothorac Surg 2004,25:844-851.
15.	Buchs NC,Pugin F,Bucher P,et al.Learning curve for robotassisted Roux-en-Y gastric bypass.Surg Endosc 2012,26,(4):1116-1121.
16.	Lee J,Yun JH,Nam KH,et al.The learning curve for robotic thyroidectomy:a multicenter study.Ann Surg Oncol,2011,18(1):226-232.
17.	Veronesi G,Galetta D,Maisonneuve P,et al.Four-arm robotic lobectomy for the treatment of early-stage lung cancer.J Thorac Cardiovasc Surg,2010,140(1):19-25.
18.	Mark M,Farid G,Barbara T,et al.The learning curve of robotic lobectomy.Int J Med Robotics Comput Assist Surg,2012,8:448-452 Kaul S,Shah NL,Menon M.Learning curve using robotic surgery.Curr Urol Rep,2006,7:125-129.
19.	罗清泉.机器人外科手术系统在普胸外科中的应用.上海医学,2011,34(1):10-11.

1. Nagahiro I,Andou A,Aoe M,et al.Pulmonary function,postoperative pain,and serum cytokine level after lobectomy:a comparison of VATS and conventional procedure.Ann Thorac Surg,2001,72(2):362-365.
2. Forster R,Storck M,Schafer JR,et al.Thoracoscopy versus thoracotomy:a prospective comparison of trauma and quality of life.Langenbecks Arch Surg,2002,387(1):32-36.
3. Dieter RA Jr,Kuzycz GB.Complications and contraindications of thoracoscopy.Int Surg,1997,82(3):232-239.
4. Augustin F,Bodner J,Wykypiel H,et al.Initial experience with robotic lung lobectomy:report of two different approaches.Surg Endosc,2011,25(1):108-113.
5. 黄佳,罗清泉,谭强.机器人外科手术系统辅助胸腔镜胸腺瘤切除手术一例.上海医学,2010,33(11):1072.
6. Maat AP,Van Doorn PA,Bogers AJ.Inclusion of the transcervical approach in the video-assisted thoracoscopic extended thymectomy(BATET)for myasthenia gravis:a prospective trial.Surg Endosc,2008,22(1):265.
7. Weksler B,Tavares J,Newhook TE,et al.Robot-assisted thymectomy is superior to transsternal thymectomy.Surg Endosc,2012,26:261-266.
8. Yim AP.Thoracoscopic thymectomy:which side to approach?Ann Thorac Surg,1997,64(2):584-585.
9. Mack MJ.Video-assisted thoracoscopy thymectomy for myasthenia gravis.Chest Surg Clin N Am,2001,11(2):389-405.
10. Goldstein SD,Yang SC.Assessment of robotic thymectomy using the Myasthenia Gravis Foundation of America Guidelines.Ann Thorac Surg,2011,89:1080-1085.
11. Ruckert JC,Ismail M,Swierzy M,et al.Thoracoscopic thymectomy with the da Vinci robotic system for myasthenia gravis.Ann NY Acad Sci,2008,1132:329-335.
12. Ruckert JC,Swierzy M,Ismail M.Comparison of robotic and nonrobotic thoracoscopic thymectomy:a cohort study.J Thorac Cardiovasc Surg,2011,141:673-677.
13. Bodner J,Wykypiel H,Greiner A,et al.Early experience with robot-assisted surgery for mediastinal masses.Ann Thorac Surg,2004,78:259-265.
14. Bodner J,Wykypiel H,Wetscher G,et al.First experiences with the da Vinci operating robot in thoracic surgery.Eur J Cardiothorac Surg 2004,25:844-851.
15. Buchs NC,Pugin F,Bucher P,et al.Learning curve for robotassisted Roux-en-Y gastric bypass.Surg Endosc 2012,26,(4):1116-1121.
16. Lee J,Yun JH,Nam KH,et al.The learning curve for robotic thyroidectomy:a multicenter study.Ann Surg Oncol,2011,18(1):226-232.
17. Veronesi G,Galetta D,Maisonneuve P,et al.Four-arm robotic lobectomy for the treatment of early-stage lung cancer.J Thorac Cardiovasc Surg,2010,140(1):19-25.
18. Mark M,Farid G,Barbara T,et al.The learning curve of robotic lobectomy.Int J Med Robotics Comput Assist Surg,2012,8:448-452 Kaul S,Shah NL,Menon M.Learning curve using robotic surgery.Curr Urol Rep,2006,7:125-129.
19. 罗清泉.机器人外科手术系统在普胸外科中的应用.上海医学,2011,34(1):10-11.

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Initial Experience of Robot-assisted Surgery for 47 Patients with Mediastinal Tumor

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