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使用锐视单孔机器人系统的单孔机器人辅助胸腔镜右下支气管袖状肺叶切除术

Single-port robot-assisted thoracoscopic right lower bronchial sleeve lobectomy utilizing the Shurui single-port robotic system.

作者信息

Li Chang, Zhu Xin-Yu, Gonzalez-Rivas Diego, Zhao Jun

机构信息

Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

Institute of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

J Thorac Dis. 2024 Nov 30;16(11):7920-7925. doi: 10.21037/jtd-24-957. Epub 2024 Nov 21.

DOI:10.21037/jtd-24-957
PMID:39678833
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11635244/
Abstract

Sleeve lobectomy has solidified its position as a preferred alternative to pneumonectomy due to its significant advantage in preserving lung function, whereas right lower lobe sleeve lobectomy remains relatively uncommon because of the higher technical challenge. With the development of minimally invasive technology and experience acquired over the years, robot-assisted thoracoscopic surgery (RATS) has shown progress and distinct advantages compared to the traditional thoracotomy and video-assisted thoracoscopic surgery (VATS) approach. Owing to its 3D vision, bendable wrist joints, and tremor filtration capabilities, this surgical technique exhibits great advantages in complex thoracic operations demanding for reconstructive procedures compared to traditional thoracoscopic surgery. The Davinci Xi system has been employed in a substantial number of sleeve resections via a single-port approach. However, the Davinci Xi system was first designed for multi-port thoracic surgery, which poses challenges for adaptation to single-port surgery. Additionally, the newer Davinci SP system, with its 2.5 cm port diameter, cannot be inserted through an intercostal incision and can only be utilized for lung surgery via a subcostal incision, thus restricting its application in complex lung surgeries such as sleeve resection. Here we present a case report on a right lower sleeve lobectomy utilizing the innovative Shurui single-port robotic system which exhibits several advantages in the realm of lung surgery compared to traditional procedures.

摘要

袖状肺叶切除术因其在保留肺功能方面的显著优势,已巩固了其作为肺切除术首选替代方案的地位,而右下叶袖状肺叶切除术由于技术挑战较高,仍然相对少见。随着微创技术的发展以及多年积累的经验,与传统开胸手术和电视辅助胸腔镜手术(VATS)方法相比,机器人辅助胸腔镜手术(RATS)已展现出进展和明显优势。由于其具备3D视觉、可弯曲的腕关节以及震颤过滤功能,与传统胸腔镜手术相比,这种手术技术在需要重建手术的复杂胸部手术中具有很大优势。达芬奇Xi系统已被大量用于单孔入路的袖状切除术。然而,达芬奇Xi系统最初是为多孔胸腔手术设计的,这给适应单孔手术带来了挑战。此外,新型的达芬奇SP系统,其端口直径为2.5厘米,无法通过肋间切口插入,只能通过肋下切口用于肺部手术,因此限制了其在诸如袖状切除术等复杂肺部手术中的应用。在此,我们报告一例使用创新的锐视单孔机器人系统进行右下袖状肺叶切除术的病例,该系统与传统手术相比在肺部手术领域展现出诸多优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e8d/11635244/1a2711e4ff25/jtd-16-11-7920-vid1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e8d/11635244/a82a78308c7a/jtd-16-11-7920-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e8d/11635244/1a2711e4ff25/jtd-16-11-7920-vid1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e8d/11635244/a82a78308c7a/jtd-16-11-7920-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e8d/11635244/1a2711e4ff25/jtd-16-11-7920-vid1.jpg

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本文引用的文献

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Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.oa.24-00026.
2
A middle lobe sparing sleeve resection versus bilobectomy for right lower central non-small cell lung cancer: a retrospective propensity score matched cohort study.中叶保留肺段切除术与肺叶切除术治疗右下肺中央型非小细胞肺癌:一项回顾性倾向评分匹配队列研究。
J Cardiothorac Surg. 2024 Apr 16;19(1):234. doi: 10.1186/s13019-024-02744-5.
3
Uniportal fully robotic-assisted sleeve resections: surgical technique and initial experience of 30 cases.
单孔全机器人辅助袖状切除术:手术技术及30例初步经验
Ann Cardiothorac Surg. 2023 Jan 31;12(1):9-22. doi: 10.21037/acs-2022-urats-23. Epub 2023 Jan 6.
4
Specific techniques for right sleeve lower lobectomy: four case reports.右肺下叶袖状切除术的具体技术:四例病例报告
Surg Case Rep. 2021 Feb 3;7(1):38. doi: 10.1186/s40792-021-01123-9.
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Robotic Sleeve Resection of the Airway: Outcomes and Technical Conduct Using Video Vignettes.机器人袖状切除术治疗气道疾病:应用视频病例的结果和技术操作。
Ann Thorac Surg. 2020 Jul;110(1):236-240. doi: 10.1016/j.athoracsur.2020.01.077. Epub 2020 Mar 6.
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Is Right Sleeve Lower Lobectomy Necessary? Is It Safe?右肺下叶袖状切除术是否必要?是否安全?
Thorac Cardiovasc Surg. 2020 Apr;68(3):235-240. doi: 10.1055/s-0038-1642597. Epub 2018 May 23.
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Sleeve Right Lower Lobectomy: a Rarely Performed Extended Resection.袖状右下叶切除术:一种很少施行的扩大切除术。
Indian J Surg. 2016 Feb;78(1):74-6. doi: 10.1007/s12262-016-1447-4. Epub 2016 Feb 10.
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Complete video-assisted thoracoscopic surgery (VATS) bronchial sleeve lobectomy.全胸腔镜辅助下支气管袖式肺叶切除术。
J Thorac Dis. 2016 Mar;8(3):553-74. doi: 10.21037/jtd.2016.01.63.
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Right lower lobe sleeve resection: bronchial flap to correct caliber disparity.右肺下叶袖状切除术:支气管皮瓣纠正支气管口径差异。
Ann Thorac Surg. 2013 Mar;95(3):1107-8. doi: 10.1016/j.athoracsur.2012.09.083.