Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Ann Thorac Surg. 2019 Jan;107(1):242-247. doi: 10.1016/j.athoracsur.2018.08.016. Epub 2018 Oct 6.
The da Vinci Single-Site platform (Intuitive Surgical, Mountain View, CA) has been applied in many fields of surgery, but use of this single-site platform in thoracic surgery has not been reported. This study reported our experiences and surgical outcomes with robotic single-site surgery in the field of thoracic surgery.
We retrospectively reviewed 14 patients who underwent robotic single-site thoracic surgery at 2 different institutions.
All 14 cases were successfully completed, without conversion to conventional multiport robotic surgery. The most frequent diagnoses were thymic cyst (n = 4) and pericardial cyst (n = 3). The median largest mass size was 4.1 cm (range, 2.0 to 6.5 cm). The median operation time was 105 minutes (range, 27 to 185 minutes). After the operation, pleural effusion occurred in 1 patient (case 7) on the side on which the operation was performed but was managed with conservative treatment. The median duration of chest tube stay was 2 days (range, 1 to 3 days), and hospital stay was 4 days (range, 3 to 11 days). The median peak pain score after the operation was 3 (range, 1 to 7). Compared with thoracoscopic single-port surgery, robotic single-site thoracic surgery showed a longer operative time and higher cost.
This study demonstrated that robotic single-site thoracic surgery for mediastinal masses is a safe and feasible procedure. Although this study reports the initial series and the cases were relatively simple, more advanced and complex procedures could be done with the advent of new technology in the near future.
达芬奇单部位手术平台（直觉外科公司，美国加利福尼亚州山景城）已应用于许多外科领域，但该单部位平台在胸外科中的应用尚未见报道。本研究报告了我们在胸外科领域应用机器人单部位手术的经验和手术结果。
我们回顾性分析了在 2 家不同机构接受机器人单部位胸科手术的 14 例患者。
所有 14 例均顺利完成，无转为常规多孔机器人手术。最常见的诊断是胸腺囊肿（n=4）和心包囊肿（n=3）。最大肿块的中位数大小为 4.1cm（范围 2.0-6.5cm）。中位数手术时间为 105 分钟（范围 27-185 分钟）。术后，1 例（病例 7）手术侧发生胸腔积液，但经保守治疗后得到控制。中位胸腔引流管留置时间为 2 天（范围 1-3 天），住院时间为 4 天（范围 3-11 天）。术后中位数的峰值疼痛评分为 3 分（范围 1-7 分）。与胸腔镜单孔手术相比，机器人单部位胸科手术的手术时间更长，费用更高。
本研究表明，机器人单部位胸腔内纵隔肿块切除术是一种安全可行的手术方法。尽管本研究报告的是初始系列，且病例相对简单，但随着新技术的出现，在不久的将来可能会进行更先进和复杂的手术。
