Hitoshi Igai, Akinobu Ida, Kazuhito Nii, Mitsuhiro Kamiyoshihara
{"title":"Robotic right upper sleeve lobectomy with bronchoplasty for primary adenocarcinoma.","authors":"Hitoshi Igai, Akinobu Ida, Kazuhito Nii, Mitsuhiro Kamiyoshihara","doi":"10.1510/mmcts.2026.033","DOIUrl":null,"url":null,"abstract":"<p><p>Sleeve lobectomy with bronchoplasty is a complex yet lung-sparing procedure traditionally performed via open thoracotomy. Robotic-assisted thoracoscopic surgery, with enhanced visualization and instrument dexterity, may facilitate this technically demanding procedure in a minimally invasive setting. We report the case of an 85-year-old man with adenocarcinoma in the right upper lobe, accompanied by an isolated intrapulmonary metastasis and an enlarged lymph node #4R and #11s, with #11s invading the orifice of the right upper lobe bronchus. The clinical stage was cT3N2aM0 (stage IIIB). Because of bronchial involvement by metastatic lymph node #11s, robotic right upper sleeve lobectomy with bronchoplasty was performed. A five-port approach was used. The right upper lobe pulmonary vessels were individually dissected and divided using robotic staplers. After sleeve resection of the bronchus, bronchial reconstruction was completed with a continuous barbed suture. The anastomosis was reinforced with a free pericardial fat pad and fibrin sealant. Console time was 226 minutes, with minimal blood loss. The chest tube was removed on postoperative Day 1, and the patient was discharged on postoperative Day 5 without complications. Pathology confirmed pT3N2bM0 adenocarcinoma with negative margins. Robotic right upper sleeve lobectomy with bronchoplasty may be a feasible minimally invasive option in selected patients requiring complex airway reconstruction.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2026 ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1510/mmcts.2026.033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Sleeve lobectomy with bronchoplasty is a complex yet lung-sparing procedure traditionally performed via open thoracotomy. Robotic-assisted thoracoscopic surgery, with enhanced visualization and instrument dexterity, may facilitate this technically demanding procedure in a minimally invasive setting. We report the case of an 85-year-old man with adenocarcinoma in the right upper lobe, accompanied by an isolated intrapulmonary metastasis and an enlarged lymph node #4R and #11s, with #11s invading the orifice of the right upper lobe bronchus. The clinical stage was cT3N2aM0 (stage IIIB). Because of bronchial involvement by metastatic lymph node #11s, robotic right upper sleeve lobectomy with bronchoplasty was performed. A five-port approach was used. The right upper lobe pulmonary vessels were individually dissected and divided using robotic staplers. After sleeve resection of the bronchus, bronchial reconstruction was completed with a continuous barbed suture. The anastomosis was reinforced with a free pericardial fat pad and fibrin sealant. Console time was 226 minutes, with minimal blood loss. The chest tube was removed on postoperative Day 1, and the patient was discharged on postoperative Day 5 without complications. Pathology confirmed pT3N2bM0 adenocarcinoma with negative margins. Robotic right upper sleeve lobectomy with bronchoplasty may be a feasible minimally invasive option in selected patients requiring complex airway reconstruction.
期刊介绍：
The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
