Download PDF
Zentralbl Chir 2023; 148(S 01): S33-S40
DOI: 10.1055/a-1993-3249
Thoraxchirurgie
Originalarbeit

Roboterassistierte anatomische Lungenresektion: Technik, Evidenz und Datenlage

Robot-assisted Lung Surgery: Techniques, Evidence and Data on Anatomical Resections
Danjouma Cheufou
1   Klinik für Thoraxchirurgie, Klinikum Würzburg Mitte gGmbH, Würzburg, Deutschland
,
Jonas Mohnke
1   Klinik für Thoraxchirurgie, Klinikum Würzburg Mitte gGmbH, Würzburg, Deutschland
,
Victor Sander
1   Klinik für Thoraxchirurgie, Klinikum Würzburg Mitte gGmbH, Würzburg, Deutschland
,
Stefanie Weckesser
1   Klinik für Thoraxchirurgie, Klinikum Würzburg Mitte gGmbH, Würzburg, Deutschland
,
Mikhail Gronostayskiy
1   Klinik für Thoraxchirurgie, Klinikum Würzburg Mitte gGmbH, Würzburg, Deutschland
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Die roboterassistierte Thoraxchirurgie (RATS) hat dank verbesserter Visualisierung und optimierter Instrumente (sog. Endowrist-Funktion) einen enormen technischen Fortschritt in der thoraxchirurgischen Versorgung von Patienten gebracht. Auch die Durchführung komplexer thorakaler oder mediastinaler chirurgischer Eingriffe, bspw. mit einer intrathorakalen Naht, sind nunmehr möglich. Infolgedessen wird diese Technologie zunehmend übernommen und in der therapeutischen Anwendung implementiert. Während die Zahl der konventionellen Thorakotomien bei Lungenkrebs weltweit zurückgeht, ist ein kontinuierlicher Anstieg der minimalinvasiven Resektionen beim Bronchialkarzinom zu beobachten. Ziel dieser Arbeit ist es, einen aktuellen Überblick über roboterassistierte Operationen beim Lungenkarzinom zu geben.

Abstract

Thanks to improved visualisation and instruments with an endowrist function, robot-assisted thoracic surgery has led to technical progress in thoracic surgery. This makes it easier to carry out complex thoracic surgical interventions, e.g. with an intrathoracic suture. As a result, this technology is increasingly being adopted and implemented in therapeutic use. Worldwide, the number of thoracotomies for lung cancer has decreased, while the number of minimally invasive surgical thoracic resections has increased. The aim of this work is to give an up-to-date overview of robotic operations on bronchial carcinoma.

Schlüsselwörter

RATS - Lobektomie - Segmentektomie - Roboterchirurgie - Lungenkarzinom

Keywords

RATS - lobectomy - segmentectomy - robotic surgery - lung cancer


Publication History

Received: 20 September 2022

Accepted after revision: 02 December 2022

Article published online:
30 January 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Rocco G, Internullo E, Cassivi SD. et al. The variability of practice in minimally invasive thoracic surgery for pulmonary resections. Thorac Surg Clin 2008; 18: 235-247
    CrossrefPubMedSearch in Google Scholar
  • 2 Johnson J, Kirby CK, Blakemore WS. Should we insist on radical pneumonectomy as routine procedure in the treatment of carcinoma of the lung?. J Thorac Surg 1958; 36: 309-315
    CrossrefPubMedSearch in Google Scholar
  • 3 Dylewski MR, Ohaeto AC, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg 2011; 23: 36-42
    CrossrefPubMedSearch in Google Scholar
  • 4 Veronesi G, Galetta D, Maisonneuve P. et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg 2010; 140: 19-25
    CrossrefPubMedSearch in Google Scholar
  • 5 Cerfolio RJ, Bryant AS. Robotic-assisted pulmonary resection – right upper lobectomy. Ann Cardiothorac Surg 2012; 1: 77-85
    CrossrefPubMedSearch in Google Scholar
  • 6 Cerfolio RJ. Robotic sleeve lobectomy: technical details and early results. J Thorac Dis 2016; 8 (Suppl. 02) S223-S226
    CrossrefPubMedSearch in Google Scholar
  • 7 Gómez-Caro A, Calvo MJ, Lanzas JT. et al. The approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy. Eur J Cardiothorac Surg 2007; 31: 203-208
    CrossrefPubMedSearch in Google Scholar
  • 8 Yang CF, D’Amico TA. Thoracoscopic segmentectomy for lung cancer. Ann Thorac Surg 2012; 94: 668-681
    CrossrefPubMedSearch in Google Scholar
  • 9 Geraci TC, Ferrari-Light D, Kent A. et al. Technique, Outcomes With Navigational Bronchoscopy Using Indocyanine Green for Robotic Segmentectomy. Ann Thorac Surg 2019; 108: 363-369
    CrossrefPubMedSearch in Google Scholar
  • 10 Oizumi H, Kanauchi N, Kato H. et al. Anatomic thoracoscopic pulmonary segmentectomy under 3-dimensional multidetector computed tomography simulation: a report of 52 consecutive cases. J Thorac Cardiovasc Surg 2011; 141: 678-682
    CrossrefPubMedSearch in Google Scholar
  • 11 Abbas AE. Surgical Management of Lung Cancer: History, Evolution, and Modern Advances. Curr Oncol Rep 2018; 20: 98
    CrossrefPubMedSearch in Google Scholar
  • 12 Jensik RJ, Faber LP, Milloy FJ. et al. Segmental resection for lung cancer. A fifteen-year experience. J Thorac Cardiovasc Surg 1973; 66: 563-572
    CrossrefPubMedSearch in Google Scholar
  • 13 Cerfolio RJ, Watson C, Minnich DJ. et al. One Hundred Planned Robotic Segmentectomies: Early Results, Technical Details, and Preferred Port Placement. Ann Thorac Surg 2016; 101: 1089-1095
    CrossrefPubMedSearch in Google Scholar
  • 14 Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995; 60: 615-622
    CrossrefPubMedSearch in Google Scholar
  • 15 Nakamura K, Saji H, Nakajima R. et al. A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol 2010; 40: 271-274
    CrossrefPubMedSearch in Google Scholar
  • 16 Nomori H, Mori T, Ikeda K. et al. Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute. J Thorac Cardiovasc Surg 2012; 144: 87-93
    CrossrefPubMedSearch in Google Scholar
  • 17 Tsutani Y, Miyata Y, Nakayama H. et al. Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage IA lung adenocarcinoma: propensity score-matched analysis in a multicenter study. J Thorac Cardiovasc Surg 2013; 146: 358-364
    CrossrefPubMedSearch in Google Scholar
  • 18 Ha KJ, Yun JK, Lee GD. et al. Surgical Outcomes of Radiographically Noninvasive Lung Adenocarcinoma according to Surgical Strategy: Wedge Resection, Segmentectomy, and Lobectomy. Korean J Thorac Cardiovasc Surg 2018; 51: 376-383
    CrossrefPubMedSearch in Google Scholar
  • 19 Bédat B, Abdelnour-Berchtold E, Perneger T. et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study. J Cardiothorac Surg 2019; 14: 189
    CrossrefPubMedSearch in Google Scholar
  • 20 Cao J, Yuan P, Wang Y. et al. Survival Rates After Lobectomy, Segmentectomy, and Wedge Resection for Non-Small Cell Lung Cancer. Ann Thorac Surg 2018; 105: 1483-1491
    CrossrefPubMedSearch in Google Scholar
  • 21 Altorki NK, Wang X, Wigle D. et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med 2018; 6: 915-924
    CrossrefPubMedSearch in Google Scholar
  • 22 Saji H, Okada M, Tsuboi M. et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet 2022; 399: 1607-1617
    CrossrefPubMedSearch in Google Scholar
  • 23 Cao C, Louie BE, Melfi F. et al. Impact of pulmonary function on pulmonary complications after robotic-assisted thoracoscopic lobectomy. Eur J Cardiothorac Surg 2020; 57: 338-342
    CrossrefPubMedSearch in Google Scholar
  • 24 Macke RA, Schuchert MJ, Odell DD. et al. Parenchymal preserving anatomic resections result in less pulmonary function loss in patients with Stage I non-small cell lung cancer. J Cardiothorac Surg 2015; 10: 49
    CrossrefPubMedSearch in Google Scholar
  • 25 Charloux A, Quoix E. Lung segmentectomy: does it offer a real functional benefit over lobectomy?. Eur Respir Rev 2017; 26: 170079
    CrossrefPubMedSearch in Google Scholar
  • 26 Nomori H, Shiraishi A, Cong Y. et al. Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy. Eur J Cardiothorac Surg 2018; 53: 640-647
    CrossrefPubMedSearch in Google Scholar
  • 27 Pardolesi A, Veronesi G. Robot-assisted lung anatomic segmentectomy: technical aspects. Thorac Surg Clin 2014; 24: 163-168
    CrossrefPubMedSearch in Google Scholar
  • 28 Kim DH, Na KJ, Park IK. et al. Long-Term Outcomes in Stage I Lung Cancer After Segmentectomy with a Close Resection Margin. J Chest Surg 2021; 54: 361-368
    CrossrefPubMedSearch in Google Scholar
  • 29 Toker A, Ozyurtkan MO, Kaba E. et al. Robotic anatomic lung resections: the initial experience and description of learning in 102 cases. Surg Endosc 2016; 30: 676-683
    CrossrefPubMedSearch in Google Scholar
  • 30 Cheufou DH, Mardanzai K, Ploenes T. et al. Effectiveness of Robotic Lobectomy-Outcome and Learning Curve in a High Volume Center. Thorac Cardiovasc Surg 2019; 67: 573-577
    Thieme ConnectPubMedSearch in Google Scholar
  • 31 Meyer M, Gharagozloo F, Tempesta B. et al. The learning curve of robotic lobectomy. Int J Med Robot 2012; 8: 448-452
    CrossrefPubMedSearch in Google Scholar
  • 32 Weksler B. Defining the learning curve for minimally invasive segmentectomy. J Thorac Cardiovasc Surg 2018; 156: 2004-2005
    CrossrefPubMedSearch in Google Scholar
  • 33 Veronesi G, Maisonneuve P, Rampinelli C. et al. Computed tomography screening for lung cancer: results of ten years of annual screening and validation of cosmos prediction model. Lung Cancer 2013; 82: 426-430
    CrossrefPubMedSearch in Google Scholar
  • 34 Servais EL, Miller DL, Thibault DP. et al. Conversion to Thoracotomy During Thoracoscopic vs Robotic Lobectomy: Predictors and Outcomes. Ann Thorac Surg 2022; 114: 409-417
    CrossrefPubMedSearch in Google Scholar
  • 35 Cao C, Cerfolio RJ, Louie BE. et al. Incidence, Management, and Outcomes of Intraoperative Catastrophes During Robotic Pulmonary Resection. Ann Thorac Surg 2019; 108: 1498-1504
    CrossrefPubMedSearch in Google Scholar
  • 36 Pardolesi A, Park B, Petrella F. et al. Robotic anatomic segmentectomy of the lung: technical aspects and initial results. Ann Thorac Surg 2012; 94: 929-934
    CrossrefPubMedSearch in Google Scholar