Robert J. Cerfolio, MD, Ayesha S. Bryant, MD, Douglas J. Minnich, MD

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Presentation transcript:

Starting a Robotic Program in General Thoracic Surgery: Why, How, and Lessons Learned Robert J. Cerfolio, MD, Ayesha S. Bryant, MD, Douglas J. Minnich, MD The Annals of Thoracic Surgery Volume 91, Issue 6, Pages 1729-1737 (June 2011) DOI: 10.1016/j.athoracsur.2011.01.104 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The surgical technique used to perform a completely portal robotic lobectomy using 4 robotic arms (CPRL-4) is shown. A right pulmonary resection is shown with the patient in the left lateral decubitus position. The pleural space is entered using a 5-mm port anteriorly in the midaxillary line (MAL) over the top of the seventh rib. Once the chest cavity is confirmed, carbon dioxide is insufflated, and then, using a 5-mm video-assisted thoracoscopic surgery camera, the surgeon makes all other incisions according to the patient's internal anatomy. The most posterior port is made next and it is at least 2 rib spaces below the major fissure. The other ports are placed in the same intercostal space. The numbers represent the robotic arms used (C = camera port, A = 15-mm access port). Note that robotic arm 3 is placed in a 5-mm port, robotic arm 2 uses an 8-mm port, and the camera can be in an 8- or 12-mm port, depending on the robotic camera used. Robotic arm 1 uses a 12-mm double cannulated port. In this way, staplers can be placed by robotic arm 1 or though the 15-mm access port. The Annals of Thoracic Surgery 2011 91, 1729-1737DOI: (10.1016/j.athoracsur.2011.01.104) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Number of robotic operations performed per month by one surgeon and as a growing percentage of his practice. The Annals of Thoracic Surgery 2011 91, 1729-1737DOI: (10.1016/j.athoracsur.2011.01.104) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions