media
posted on 2018-10-24, 18:50 authored by Vijay Joshi, Dennis Wigle<p>The patient was a 71-year-old woman with a bronchiectatic
left upper lobe lesion that was under surveillance. She had a biopsy-proven
adenocarcinoma in the left lower lobe, normal pulmonary function tests, and no
signs of nodal disease or spread outside of the left lung. The initial surgical
plan was a left video-assisted thoracoscopic (VATS) lobectomy. Wedge resection
of the bronchiectatic area in the upper lobe was performed. However, the intraoperative
frozen sectioning showed adenocarcinoma, so an upper lobectomy was performed.
The surgical plan was then changed, as multiple nodules were palpated in the
lower lobe. The patient was woken up and she consented to a pneumonectomy. A
robotic approach was utilized, incorporating the existing VATS ports. The left
main pulmonary artery, lower lobe vein, and left main bronchus were
successfully stapled with traditional robotic staplers. The specimen was
removed by extending an access port to join a working port. The patient was
discharged on postoperative day three with no complications.</p>
<p><b>Suggested Reading </b></p>
<p>Khan N, Fikfak V, Chan EY, Kim MP. “Five on a dice” port placement
allows for successful robot-assisted left pneumonectomy. <i><a href="https://doi.org/10.1055/s-0037-1613714">Thorac Cardiovasc Surg
Rep. 2017;6(1):e42-e44</a></i>.</p>


