Robotic pneumonectomy

Abstract

Pneumonectomy is an extensive surgical resection sometimes required to treat centrally located lung cancer or tumor infiltrating different pulmonary lobes across fissures. For several years, this surgical procedure was performed by an open approach; more recently, with the advent of less invasive approaches [robotic-assisted surgery and video-thoracoscopic thoracic surgery (VATS)], pneumonectomy has been performed by a minimally invasive approach which showed, compared to a standard thoracotomic approach, a real benefit for patients in terms of minor morbidity, minor hospital stay together with good oncological results. In the last decade we assisted to an increasing adoption of the robotic approach in thoracic surgery mainly due to the features of this technique respect to VATS: a good magnification of the anatomic structures, a best vision, an increased degree of freedom in movements, and absence of the tremor. Many reports on thoracic robotic approach described the technique, the advantages, and reported mainly data and solid experience in performing lobectomy and segmentectomy in early-stage lung cancer but very few centers performed robotic pneumonectomy. We sought to describe in this article our experience in performing robotic pneumonectomy, reporting the indications, the surgical technique, and pros and cons of this less