Endoscopic Computer-Enhanced Mediastinal Mass Resection Using Robotic Technology
DOI:
https://doi.org/10.1532/hsf.601Abstract
Background: Robotic technology can be used to facilitate the performance of a variety of cardiac surgical procedures, including internal mammary artery mobilization, atrial septal defect repair, mitral valve repair, and coronary artery bypass grafting. This report describes the use of robotic technology for resection of mediastinal masses.
Methods: Two patients underwent mediastinal mass resection performed using the Da Vinci robotic surgical system (Intuitive Surgical, Mountain View, CA, USA). The first patient had a 3 3 4-cm mass located in the left superior-posterior mediastinum, abutting the left subclavian artery. The second patient had a 2.7 3 1.9-cm mass located in the left chest wall.
Results: Both mediastinal masses were successfully excised using a totally endoscopic robotic approach with three 1-cm incisions. Neither case was converted to a thoracotomy or sternotomy. There were no postoperative complications. Both patients were discharged on postoperative day 2.
Conclusions: Resection of a mediastinal mass can be performed safely and effectively using robotic technology. By minimizing surgical trauma, this approach is likely to yield a hastened postoperative recovery and improved quality of life.
References
Chitwood WR Jr, Nifong LW, Elbeery JE, et al. 2000. Robotic mitral valve repair: trapezoidal resection and prosthetic annuloplasty with the Da Vinci surgical system. J Thorac Cardiovasc Surg 120:1171-2.nCohn LH, Adams DH, Couper GS, et al. 1997. Minimally invasive aortic valve replacement. Semin Thorac Cardiovasc Surg 9:331-6.nCosgrove DM, Sabik JF. 1996. Minimally invasive approach to aortic valve operations. Ann Thorac Surg 62:596-7.nCosgrove DM, Sabik JF, Navia JL. 1998. Minimally invasive valve surgery. Ann Thorac Surg 65:1535-8.nDamiano RJ, Ehrman WJ, Dicko CT, et al. 2000. Initial United States clinical trial of robotically assisted endoscopic coronary artery bypass grafting. J Thorac Cardiovasc Surg 119:77-82.nFalk V, Diegeler A, Walther T, et al. 2000. Total endoscopic computer enhanced coronary artery bypass grafting. Eur J Cardiothorac Surg 17:38-45.nFalk V, Diegler A, Walther T, et al. 2000. Developments in robotic cardiac surgery. Curr Opin Cardiol 15:378-87.nKappert U, Cichon R, Schneider J, et al. 2000. Robotic coronary artery surgery--the evolution of a new minimally invasive approach in coronary artery surgery. Thorac Cardiovasc Surg 48:193-7.nLaPietra A, Grossi EA, Derivaux CC, et al. 2000. Robotic-assisted instruments enhance minimally invasive mitral valve surgery. Ann Thorac Surg 70:835-8.nMohr FW, Falk V, Diegeler A, et al. 2001. Computer-enhanced "robotic" cardiac surgery: experience in 148 patients. J Thorac Cardiovasc Surg 121:842-53.nNataf P, Al-Attar N, Ramadan R, et al. 2000. Thoracoscopic IMA take down. J Card Surg 15:278-82.nPrasad SM, Ducko CT, Stephenson ER, et al. 2001. Prospective clinical trial of robotically assisted endoscopic coronary grafting with 1-year follow up. Ann Surg 233:725-32.nStephenson ER, Sankholkar S, Ducko CT, et al. 1998. Robotically assisted microsurgery for endoscopic coronary artery bypass grafting. Ann Thorac Surg 66:1064-7.nArgenziano M, Oz MC, DeRose JJ, et al. 2002. Totally endoscopic atrial septal defect repair utilizing robotic assistance. Heart Surg Forum 5:294-7.n
