Wu Ching Feng, Cheng Chuan, Suen Ka Hei, Stein Hubert, Chao Yin Kai
Division of Thoracic Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333323, Taiwan.
Division of Thoracic Surgery, New Taipei Municipal Tu-Cheng Hospital, New Taipei City 25162, Taiwan.
Diagnostics (Basel). 2023 Jan 26;13(3):460. doi: 10.3390/diagnostics13030460.
Despite the recent introduction of technologically advanced single-port (SP) robotic systems, their use in the field of thoracic surgery has been rarely explored. Here, we report our preclinical experience concerning SP robotic thoracic surgery using the da Vinci SP system. The da Vinci SP system was used to perform subcostal anatomical lung resection and subxiphoid thymectomy in three cadavers. The operative settings that best met the surgeon's requirements for each resection were also determined. Four subcostal anatomical lung resections and two subxiphoid thymectomies were completed. While both procedures did not require additional incisions, the use of an observation port in the intercostal spaces was strongly recommended to safely create subcostal access. Dissection of hilar structures and mediastinal lymph nodes was feasible. However, due to the current unavailability of a robotic stapler, a handheld stapling instrument was required to perform a transection of vital structures. When the stapling process proved to be difficult, the table surgeon temporarily removed a robotic arm to acquire the necessary space to complete the procedure. Our data represent a promising preclinical step in understanding the feasibility of using the da Vinci SP system to perform an SP subcostal anatomical lung resection and a subxiphoid thymectomy.
尽管最近引入了技术先进的单孔（SP）机器人系统，但它们在胸外科领域的应用却很少被探索。在此，我们报告我们使用达芬奇SP系统进行单孔机器人胸外科手术的临床前经验。使用达芬奇SP系统在三具尸体上进行了肋下解剖性肺切除术和剑突下胸腺切除术。还确定了最符合外科医生对每种切除术要求的手术设置。完成了4例肋下解剖性肺切除术和2例剑突下胸腺切除术。虽然这两种手术都不需要额外的切口，但强烈建议在肋间使用观察孔，以安全地建立肋下入路。肺门结构和纵隔淋巴结的解剖是可行的。然而，由于目前没有机器人吻合器，需要使用手持吻合器械来横断重要结构。当吻合过程证明困难时，手术台旁的外科医生会临时移除一个机器人手臂以获得完成手术所需的空间。我们的数据代表了在理解使用达芬奇SP系统进行单孔肋下解剖性肺切除术和剑突下胸腺切除术可行性方面一个有前景的临床前步骤。
