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Robotic circumferential tracheal resection and reconstruction via a completely portal approach.

ABSTRACT: Robotic surgery for circumferential tracheal resection and reconstruction has not previously been reported. Herein we describe the case of a 48-year-old man with primary extra-luminal tracheal leiomyosarcoma. A preoperative bronchoscopy exam and chest computed tomography revealed a tracheal neoplasm, which derived from lower membranous trachea and nearly obstructed the orifice of the left main bronchus. The patient underwent circumferential tracheal resection and reconstruction via a completely portal robotic approach with four arms. Benefitting from flexible instruments and a three-dimensional magnified view, telescope anastomosis was performed and modulated. No postoperative complications presented. Follow-up showed the reconstructed trachea without stenosis or recurrence.

SUBMITTER: Qiu T

PROVIDER: S-EPMC6360223 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Robotic circumferential tracheal resection and reconstruction via a completely portal approach.

Qiu Tong T Zhao Yandong Y Song Jianfang J Jiao Wenjie W

Thoracic cancer 20181229 2

Robotic surgery for circumferential tracheal resection and reconstruction has not previously been reported. Herein we describe the case of a 48-year-old man with primary extra-luminal tracheal leiomyosarcoma. A preoperative bronchoscopy exam and chest computed tomography revealed a tracheal neoplasm, which derived from lower membranous trachea and nearly obstructed the orifice of the left main bronchus. The patient underwent circumferential tracheal resection and reconstruction via a completely ...[more]

PMID: 30593724

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Project description:BackgroundOpen pancreatoduodenectomy with vein resection (OPD-VR) is now standard of care in patients who responded to neoadjuvant therapies. Feasibility of robotic pancreatoduodenectomy (RPD) with vein resection (RPD-VR) was shown, but no study provided a detailed description of the technical challenges associated with this formidable operation. Herein, we describe the trips and tricks for technically successful RPD-VR.MethodsThe vascular techniques used in RPD-VR were borrowed from OPD-VR, as well as from our experience with robotic transplantation of both kidney and pancreas. Vein resection was classified into 4 types according to the international study group of pancreatic surgery. Each type of vein resection was described in detail and shown in a video.ResultsBetween October 2008 and November 2021, a total of 783 pancreatoduodenectomies were performed, including 233 OPDs-VR (29.7%). RPD was performed in 256 patients (32.6%), and RPDs-VR in 36 patients (4.5% of all pancreatoduodenectomies; 15.4% of all pancreatoduodenectomies with vein resection; 14.0% of all RPDs). In RPD-VR vein resections were: 4 type 1 (11.1%), 10 type 2 (27.8%), 12 type 3 (33.3%) and 10 type 4 (27.8%). Vascular patches used in type 2 resections were made of peritoneum (n = 8), greater saphenous vein (n = 1), and deceased donor aorta (n = 1). Interposition grafts used in type 4 resections were internal left jugular vein (n = 8), venous graft from deceased donor (n = 1) and spiral saphenous vein graft (n = 1). There was one conversion to open surgery (2.8%). Ninety-day mortality was 8.3%. There was one (2.8%) partial vein thrombosis, treated with heparin infusion.ConclusionsWe have reported 36 technically successful RPDs-VR. We hope that the tips and tricks provided herein can contribute to safer implementation of RPD-VR. Based on our experience, and according to data from the literature, we strongly advise that RPD-VR is performed by expert surgeons at high volume centers.

Dataset Information

Robotic circumferential tracheal resection and reconstruction via a completely portal approach.

Publications

Robotic circumferential tracheal resection and reconstruction via a completely portal approach.

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