Objective Robotic telemanipulation systems have been introduced recently to enhance the surgeon's dexterity and visualization in endoscopic surgery and thus facilitate refined dissection, suturing, and knot tying. This study examined the technical feasibility of performing safe and efficient robot-assisted, hand-sewn endoscopic airway reconstruction in a rabbit model. Methods A total of 18 tracheal anastomoses were performed in rabbits, with 6 anastomoses performed endoscopically using the da Vinci Surgical system (Robot group), 6 anastomoses performed using traditional thoracoscopic surgical instruments (VATS group), and 6 anastomoses performed using open surgical instruments (Open group). Anastomosis time and complications were recorded. The effectiveness of anastomoses was evaluated by postoperative observation of all rabbits for 8 weeks and measurement of anastomotic stricture and pathologic findings. These parameters and anastomosis time were compared between groups. Results In all cases in the Robot group, the procedure was completed endoscopically. No perioperative or postoperative complications were encountered. Mean procedure time of the Robot group was 14.1 ± 2.6 minutes (mean ± standard deviation). Anastomosis time in the Robot group was significantly shorter than in the VATS group (33.5 ± 5.2 minutes, P = .0039) and was not significantly different in the Open group (11.4 ± 2.3 minutes, P = .1282). All anastomoses in the Robot group remained mechanically intact, and all parameters were comparable with those of the open surgery group. Conclusions The technical feasibility of performing safe and efficient robot-assisted endoscopic airway reconstruction was repeatedly demonstrated in a rabbit model. Robotic assistance significantly improved the time associated with and the quality of endoscopic airway reconstruction.
Background In robotic surgery, the ideal position of the system, as well as the optimal working angles and the proper positioning of the thoraco ports position is very important. No robot-assisted bronchoplasty has been reported. Our study describes use of the da VinciTM surgical system (Intuitive Surgical, Inc.) for robotic sleeve upper lobectomy in a human fresh cadaver.
#1Bernard J. Park(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 42
#1Bernard J. Park(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 22
Last. Valerie W. Rusch(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 146
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Objectives There is little experience with telerobotic assistance for video-assisted thoracic surgical lobectomy. We developed a technique for robotic assistance during video-assisted thoracic surgical lobectomy and report our initial results. Methods Video-assisted thoracic surgical lobectomy with the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, Calif) was attempted in 34 patients (median age, 69.0 years; age range, 12-85 years). Robotic instruments were used for individual dissecti...
#2Matthias Zitt(Innsbruck Medical University)H-Index: 16
Last. Thomas Schmid(Innsbruck Medical University)H-Index: 35
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Background Robotic surgical systems are most effective for operations in areas that are small and difficult to reach. Ideal indications for this new technology have yet to be established. The esophagus possesses attributes that are interesting for general thoracic robotic surgeons. Methods Robotic-assisted thoracoscopic surgery (RATS) using the da Vinci system (Intuitive Surgical, Inc, Mountain View, CA) was performed in six patients with esophageal tumors. This comprised the dissection of the i...
Last. Thomas Schmid(University of Innsbruck)H-Index: 35
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Abstract Background We report the experience of a single institution with the minimally invasive resection of mediastinal masses using the da Vinci robotic surgical system. Methods From August 2001 to June 2003, 14 patients (5 men and 9 women aged from 21 to 77 years) with mediastinal masses were operated on minimally invasively with the da Vinci robotic system. This consisted of 9 thymectomies (6 thymomas, 2 nonatrophic thymic glands, 1 thymic cyst), 3 resections of paravertebral neurinomas, 1 ...
Background Robotic surgery systems were introduced to overcome the disadvantages of endoscopic surgery. The goal of this study was to assess whether robot assistance could support endoscopic surgeons in performing a complex endoscopic task.
Abstract Background. Reconstruction of the infrarenal aorta for aneurysms is routinely performed through laparotomy. A less invasive videoscopic approach has not gained wide acceptance due to technical difficulties. Robotic systems could potentially improve imaging of the operative field and surgeon's dexterity during videoscopic surgery and therefore might facilitate the performance of this procedure. The aim of this animal study was to compare the safety and efficacy of a robot-assisted videos...
Objectives: The da Vincie surgical robotic system was purchased at our institution in June 2001. The aim of this trial was to evaluate the applicability of the da Vincie operation robot for general thoracic procedures. Methods: The da Vincie surgical system consists of a console connected to a surgical arm cart, a manipulator unit with two instrument arms and a central arm to guide the endoscope. The surgical instruments are introduced via special ports and attached to the arms of the robot. The...
Objective: Computer (robotic) enhancement has been used to facilitate simple thoracoscopic procedures such as internal mammary artery (IMA) mobilization. This report describes the use of robotic technology in advanced thoracoscopic procedures. Methods: Ten patients underwent advanced thoracoscopic procedures utilizing the Da Vinci robotic surgical system (Intuitive Surgical, Mountain View, CA) at our institution. Results: Patients 1 – 6 underwent endoscopic phrenic nerve mobilization with insert...
Introduction: Robotic telemanipulation systems have been introduced recently to enhance the surgeon's dexterity and visualization in videoscopic surgery in order to facilitate refined dissection, suturing, and knot tying. The aim of this study was to demonstrate the technical feasibility of performing a safe and efficient robot-assisted handsewn laparoscopic intestinal anastomosis in a pig model. Methods: Thirty intestinal anastomoses were performed in pigs. Twenty anastomoses were performed lap...
Objective: Recently, robots have been introduced into surgical procedures in an attempt to facilitate surgical performance. The purpose of this study was to develop a technique to perform thoracoscopic lung resection using a telemanipulation system. Methods: We have used a robotic system to perform thoracoscopic surgery in 12 cases: five lobectomies, three tumor enucleations, three excisions and one bulla stitching completed with fibrin glue for spontaneous pneumothorax. The operations were perf...
Abstract Objective This study aimed to evaluate the surgical and oncologic outcomes of robotic sleeve lobectomy in comparison with video-assisted thoracoscopic surgery (VATS) and open surgery. Methods Surgical outcomes in patients with non-small cell lung cancer (NSCLC) who underwent sleeve lobectomy via robotic, VATS and thoracotomy were assessed using Chi-square test, Fisher’s exact test, and Kruskal-Wallis rank sum test. Log-rank test and Cox proportional hazards model were used in survival a...
Background: Robotic systems have been used to enhance the surgeon’s dexterity and visualization in endoscopic surgery and thus facilitate refined dissection, suturing, and knot tying. We describe use of the da Vinci surgical system for robotic-assisted thoracoscopic bronchoplasty in patient with centrally located lung cancer. Methods: We used three robotic ports (a 12-mm trocar for the 30°-down camera and two 8-mm trocars for the robotic instrument arms) and one utility incision for assistance a...
#1Jay K. Ferrell(University of Texas Health Science Center at Houston)H-Index: 3
#2Soham Roy(University of Texas Health Science Center at Houston)H-Index: 14
Last. Sancak Yuksel(University of Texas Health Science Center at Houston)H-Index: 6
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Objectives/Hypothesis To report preliminary experience in the utilization of transoral robotic surgical (TORS) techniques in pediatric airway surgery. Study Design Retrospective case series. Methods A retrospective chart review was performed on all pediatric patients undergoing robotic airway surgery at a university-based children's hospital between August 2010 and December 2012. Results Three pediatric patients underwent robotic repair of various airway anomalies between August 2010 and Decembe...
Objectives A new method was developed to harvest bilateral internal thoracic artery grafts using a subxiphoid approach and robotic assistance. The present study compared the potential utility of the subxiphoid method with that of the lateral thoracic approach. Methods The first part of the study examined the optimal placement of the instrument ports to maximize the robotic arms' range of motion. The second part of the study examined the 2 approaches for harvesting bilateral internal thoracic art...
OBJECTIVES: Bronchial-origin involvement by endobronchial tumours or direct invasion by tumour or metastatic lymph nodes is a relative contraindication for video-assisted thoracoscopic (VATS) lobectomy. However, selected cases can be resected by VATS bronchoplasty. METHODS: Between 2006 and 2009, 21 of 231 (9.1%) VATS lobectomy cases underwent VATS bronchoplasty. Cases with endobronchial involvement and limited non-bulky invasion of bronchus by tumour or metastatic nodes without major vascular i...
Background Natural orifice translumenal endoscopic surgery (NOTES) is a minimally invasive operation using devices such as flexible endoscopes and linear or circular staplers. Nevertheless, hand-sewn anastomosis in NOTES remains challenging. This study aimed to investigate the feasibility of transrectal robotic NOTES requiring intracorporeal small intestinal anastomosis and closure of the rectal anterior wall incision in a relevant human model.
Background The U-clip anastomotic device was developed to facilitate interrupted anastomoses without the need to tie sutures. Recently, this technology has been expanded into various fields of surgery. However, in the field of airway reconstruction, there have been no previous reports of this technology being used. The present study examined the technical feasibility of performing safe and efficient robot-assisted endoscopic airway reconstruction using nitinol U-clips in rabbits.
As thoracoscopic procedures expand in their application to more complex procedures, sleeve lobectomies might be performed minimally invasive in carefully selected patients. This chapter gives a short overview of indications and contraindications, reasons for selecting a robotic approach, and a detailed description of a clinical minimally invasive robotic assisted sleeve lobectomy.
Few studies have described video-assisted thoracic surgery (VATS) to bronchoplasty with pulmonary resection. Here, we report the successful implementation of VATS bronchoplasty, as determined retrospectively. Between 2005 and 2010, 362 patients underwent elective lung resection for malignant or benign lung tumors. Of these patients, VATS lobectomy with bronchoplasty was performed in seven patients (four men, three women; median age, 72.9 years). The medical records were retrospectively reviewed....
With the increasing recognition of the benefits of minimally invasive surgery, surgical technology has evolved significantly since Jacobeaus' first attempt at thoracoscopy 100 years ago. Currently, video-assisted thoracic surgery occupies a significant role in the diagnosis and treatment of benign and malignant diseases of the chest. However, the clinical application of video-assisted thoracic surgery is limited by the technical shortcomings of the approach. Although the da Vinci system (Intuiti...