Microlobectomy: A Novel Form of Endoscopic Lobectomy

TY - JOUR

T1 - Microlobectomy

T2 - A Novel Form of Endoscopic Lobectomy

AU - Dunning, Joel

AU - Elsaegh, Mohamed

AU - Nardini, Marco

AU - Gillaspie, Erin A

AU - Petersen, Rene Horsleben

AU - Hansen, Henrik Jessen

AU - Helsel, Bryan

AU - Naase, Hatam

AU - Kornaszewska, Malgorzata

AU - Will, Malcolm B

AU - Walker, William S

AU - Wigle, Dennis

AU - Blackmon, Shanda Haley

PY - 2017/7/1

Y1 - 2017/7/1

N2 - OBJECTIVE: Microlobectomy is a novel form of videoscopic-assisted thoracic surgery lobectomy. Strict inclusion criteria consist of the following: no intercostal incisions greater than 5 mm, 12 mm subxiphoid port, subxiphoid removal of the specimen, total endoscopic technique with CO2 insufflation, vision through a 5-mm camera, stapling via the subxiphoid port, or with 5-mm stapling devices.METHODS: The combined early experiences of six hospitals from three countries were combined from September 2014 to May 2016. During that time, the study represents a consecutive cohort study of this technique.RESULTS: Seventy-two patients underwent microlobectomy. The median (range) age was 66 (27-82). Half of the patients were female. There were 48 right-sided resections and 24 on the left. There were four segmental resections and there was one right pneumonectomy. Four operations were performed robotically (with 8-mm intercostal incisions). The median (range) operative time was 180 (94-285) minutes and the blood loss was 118 (5-800) mL. There were three conversions to thoracotomy and two conversions to videoscopic-assisted thoracic surgery by means of an intercostal utility incision to complete the operation. The median (range) length of stay was 3 (1-44) days and 30 patients (42%) when home by day 2 and 16 patients (22%) were discharged on day 1. There were no deaths. Five patients (7%) had a prolonged airleak. There were no wound infections and there was one incisional hernia.CONCLUSIONS: We believe that microlobectomy is an interesting novel form of videoscopic-assisted thoracic surgery lobectomy and has several theoretical advantages. We have presented our early results and hope that this will stimulate others to investigate this type of videoscopic-assisted thoracic surgery lobectomy further.

AB - OBJECTIVE: Microlobectomy is a novel form of videoscopic-assisted thoracic surgery lobectomy. Strict inclusion criteria consist of the following: no intercostal incisions greater than 5 mm, 12 mm subxiphoid port, subxiphoid removal of the specimen, total endoscopic technique with CO2 insufflation, vision through a 5-mm camera, stapling via the subxiphoid port, or with 5-mm stapling devices.METHODS: The combined early experiences of six hospitals from three countries were combined from September 2014 to May 2016. During that time, the study represents a consecutive cohort study of this technique.RESULTS: Seventy-two patients underwent microlobectomy. The median (range) age was 66 (27-82). Half of the patients were female. There were 48 right-sided resections and 24 on the left. There were four segmental resections and there was one right pneumonectomy. Four operations were performed robotically (with 8-mm intercostal incisions). The median (range) operative time was 180 (94-285) minutes and the blood loss was 118 (5-800) mL. There were three conversions to thoracotomy and two conversions to videoscopic-assisted thoracic surgery by means of an intercostal utility incision to complete the operation. The median (range) length of stay was 3 (1-44) days and 30 patients (42%) when home by day 2 and 16 patients (22%) were discharged on day 1. There were no deaths. Five patients (7%) had a prolonged airleak. There were no wound infections and there was one incisional hernia.CONCLUSIONS: We believe that microlobectomy is an interesting novel form of videoscopic-assisted thoracic surgery lobectomy and has several theoretical advantages. We have presented our early results and hope that this will stimulate others to investigate this type of videoscopic-assisted thoracic surgery lobectomy further.

U2 - 10.1097/IMI.0000000000000394

DO - 10.1097/IMI.0000000000000394

M3 - Journal article

C2 - 28763351

SN - 1556-9845

VL - 12

SP - 247

EP - 253

JO - Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery

JF - Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery

IS - 4

ER -