Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system
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CASE REPORT
Open Access
Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system Yandong Zhao*, Wenjie Jiao, Xiaoyang Ren, Liangdong Zhang, Tong Qiu, Bo Fu and Lei Wang
Abstract Background: Despite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system. Case presentation: A case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful. Conclusions: Robotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience. Keywords: Sleeve lobectomy, Lung cancer surgery, Robot-assisted lung resection, Minimally invasive surgery
Background Robot-assisted surgery using the da Vinci surgical system has became an extension of the minimally invasive lobectomy spectrum because of excellent operability under the clear vision of a three-dimensional high-definition camera. The robotic surgery for pulmonary resection is safe and efficient and has similar survival rates compared with the open and VATS approaches. Case presentation A 57-year old female, nonsmoker with a mass in left lung revealed by routine physical examination. CT scan revealed a 3 × 3 × 3 cm mass located at the dorsal segment of left lower lobe and projected into the lobe bronchus. Adenocarcinoma was diagnosed by bronchoscope examination (Fig. 1). The left main and upper lobe bronchus were not involved. The pulmonary artery and vein were free of tumor. Before the operation, the pulmonary function test, blood gas analysis, cardiac evaluation and basic examinations showed normal with no other comorbidities. The operation was performed using the Da Vinci surgical system by Dr. Jiao in Jan 29, 2015. * Correspondence: [email protected] The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong 266003, China
Surgical technique The patient received general anesthesia with dual-lumen endotracheal intubation. Then positioned in the lateral decubitus position with the bed flexed to increase the intercostal space. A 12 mm port in the 7th intercostal space in the midaxillary line was placed as observing hole for camera. Other two incisions were made in the 4th intercostal space in the anterioraxillary line for the left arm and the 7th intercostals space in the subscapular line for the right arm respectively. The robotic surgical system was then brought into position and placed cephalad to the patient. One assistant on the patient’s right side (Fig. 2). A 25 mm incision in the 6th intercostal space in the anterioraxillary line for assistant instruments. We used an electrical hook in right arm to divide and a forceps in left arm for grasp
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