Preliminary experiences with the da Vinci S surgical system in thoracic surgery / 中国医师杂志

ABSTRACT

Objective The goal of this report was to evaluate the applicability of the da Vinci S surgical system in thoracic surgery.Methods The da Vinci S surgical system consists of a console, a patient cart, and a vision system.The patient cart loading with 3 robot arms and 1 central endoscope arm connects the console which commands the movements of the arm tips.The robot arm tips are introduced via small chest wall ports and attached to the arms of the robot.The surgeon, sitting at the console, manipulates highly sensitive sensors that transfer the surgeon's movements to the arm tips.The so called EndoWrist'technology offers up , down, left, right, and twist, seven degrees of movements, thus exceeding the capacity of a surgeon's hand in open surgery.17 intrathoracic lesion cases, including 12 Myasthenia Gravis, 1 diaphragm hernia, 2 esophageal cancer, 1 pulmonary cancer , 1 pneumothorax, were evaluated for clinical application of the da Vinci S surgical system.Results Out of 17 surgical procedures, 14 procedures were done using the robot from beginning to the end, including 12 thymectomies, 1 diaphragm hernia repair, 1 pulmonary bleb dissection.Only gastric mobilizations, the abdominal part procedures were done using the da Vinci S system, and the thoracic part procedures were done through small incision thoracotomy in 2 cases with esophageal cancer.One resection of left upper lobectomy had to be converted due to surgical problem.The postoperative courses were uneventful.Conclusion The da Vinci operating robot can do nearly all kinds of thoracic operations.Advanced general thoracic procedures can be performed safely and effectively with the da Vinci S robot allowing precise dissection.This benefit becomes evident most elegantly in thymectomies.The robot operation procedures can be done by the doctors with open and assisted thoracopic surgery experiences and other personnels getting trained in a short period of time, but case selection and preparing emergency thoracotomy at any time is needed to ensure the patient safety.