Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jun;12(6):3404-3410.
doi: 10.21037/jtd.2020.02.53.

Robotic segmentectomy: indication and technique

Gianluca Perroni  1 , Giulia Veronesi  2   3
Affiliations
Review

Robotic segmentectomy: indication and technique

Gianluca Perroni et al. J Thorac Dis. 2020 Jun.

Abstract

Use of low-dose CT scan allows detection of lung cancer at early stages, enabling a more conservative surgery and a better long-term survival in those patients. In this scenario, intentional anatomical segmentectomy is gaining consent over standard lobectomy among surgeons. A minimally invasive approach such as VATS reduced invasiveness and complication rate compared to open surgery, but this technique comes also with some disadvantages in terms of dexterity and intuitiveness. Robotic surgery allows to overcome those limitations, making segmentectomies easier and safer to perform. In addition, it offers the possibility to utilize intravenous indocyanine green to define the intersegmental plane, allowing a more precise surgery. We reviewed the literature and describe the technique of the robot assisted segmentectomy with a focus on the new technologies available nowadays.

Keywords: Segmentectomy; indocyanine green (ICG); minimally invasive thoracic surgery; robotic.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.02.53). The series “Early Stage Lung Cancer: Sublobar Resections are a Choice?” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
3D reconstruction using visible patients of a nodule of S3.
Figure 2
Figure 2
The bronchoscope is visible inside the target segmental branch using the camera in the firefly mode.
Figure 3
Figure 3
After closure of segmental artery, target segment does not enhance when Indocyanine green EV is administered and firefly mode is on.
See this image and copyright information in PMC

References

    1. Osarogiagbon RU, Veronesi G, Donington J, et al. Early-Stage NSCLC: Advances in Thoracic Oncology 2018. J Thorac Oncol. 2019;14:968-78. 10.1016/j.jtho.2019.02.029 - DOI - PMC - PubMed
    1. Jensik RJ, Faber LP, Milloy FJ, et al. Segmental resection for lung cancer: a fifteen-year experience. J Thorac Cardiovasc Surg 1973;66:563-72. 10.1016/S0022-5223(19)40590-4 - DOI - PubMed
    1. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995;60:615-22; discussion 622-3. 10.1016/0003-4975(95)00537-U - DOI - PubMed
    1. Okada M, Yoshikawa K, Hatta T, et al. Is segmentectomy with lymph node assessment an alternative to lobectomy for non-small cell lung cancer of 2 cm or smaller?. Ann Thorac Surg 2001;71:956-60; discussion 961. 10.1016/S0003-4975(00)02223-2 - DOI - PubMed
    1. Cao C, Chandrakumar D, Gupta S, et al. Could less be more?-A systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection. Lung Cancer 2015;89:121-32. 10.1016/j.lungcan.2015.05.010 - DOI - PubMed