초록접수 현황
| 14F-089 | Video session발표 |
Completely Portal Robotic Left Lower Lobectomy with Complete Mediastinal Lymph Node Dissection Using 4 Arms; Fissureless Technique
박성용
아주대학교 의과대학 흉부외과학교실
Background : This video demonstrates the ‘fissureless technique’of lobectomy in patient with incomplete fissure using Da Vinci Robot system using 4 arms.
Methods : A 74-year-old female patient, with a history of hypertension, coronary artery occlusive disease with stent insertion and panic disorder was diagnosed as lung adenocarcinoma at left lower lobe. Clinical stagre was T2aN0M0. Completely portal robotic left lower lobectomy with complete mediastinal lymph node dissection using 4 arms was performed.
Results : Two 12mm trocars and one 8mm, 5mm trocars were made along the 7th intercostal space. One additional 8mm trocar was made on 5th intercostal space at anterior axillary line. Working window was not made. 10mmHg CO2 insufflation was maintained during operation. Because the fissure was not divided, fissureless technique was applied. First, left inferior pulmonary vein was divided, left lower lobar bronchus was stapled. After complete dissection of N1 lymph nodes around the pulmonary artery basal branches, pulmonary artery was stapled. Then fissure was divided with 4 linear staplers. Operation time was 180 minutes and robot console time was 152 minutes. Blood loss was 20cc. The chest drain was removed on the 3th postoperative day. The patient was discharged on 4th postoperative day without postoperative complication.
Conclusion : The fissureless technique can be performed safely with Robotic system.
Methods : A 74-year-old female patient, with a history of hypertension, coronary artery occlusive disease with stent insertion and panic disorder was diagnosed as lung adenocarcinoma at left lower lobe. Clinical stagre was T2aN0M0. Completely portal robotic left lower lobectomy with complete mediastinal lymph node dissection using 4 arms was performed.
Results : Two 12mm trocars and one 8mm, 5mm trocars were made along the 7th intercostal space. One additional 8mm trocar was made on 5th intercostal space at anterior axillary line. Working window was not made. 10mmHg CO2 insufflation was maintained during operation. Because the fissure was not divided, fissureless technique was applied. First, left inferior pulmonary vein was divided, left lower lobar bronchus was stapled. After complete dissection of N1 lymph nodes around the pulmonary artery basal branches, pulmonary artery was stapled. Then fissure was divided with 4 linear staplers. Operation time was 180 minutes and robot console time was 152 minutes. Blood loss was 20cc. The chest drain was removed on the 3th postoperative day. The patient was discharged on 4th postoperative day without postoperative complication.
Conclusion : The fissureless technique can be performed safely with Robotic system.
책임저자: 박성용
아주대학교 의과대학 흉부외과학교실
연락처 : 박성용, Tel: 031-219-5210 , E-mail : psy1117@hanmail.net
