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Review
. 2023 Mar 23:10:1090080.
doi: 10.3389/fsurg.2023.1090080. eCollection 2023.

Robotic segmentectomy for early-stage lung cancer

Elisabeth Savonitto  1 , Kazuhiro Yasufuku  2 , Alison M Wallace  1
Affiliations
Review

Robotic segmentectomy for early-stage lung cancer

Elisabeth Savonitto et al. Front Surg. .

Abstract

Lobectomies have long been the gold standard for surgical treatment of early-stage non-small cell lung cancer (NSCLC), with segmentectomies limited to instances of benign disease or as an alternative in patients where lung preservation is indicated. However, a recently published randomized control trial has demonstrated the superiority of segmentectomy over lobectomy in terms of overall survival for early-stage lung cancer. Segmentectomy could thus be considered a standard procedure for small-sized peripheral NSCLC. While segmentectomy via video-assisted thoracic surgery (VATS) is the most widespread approach, development in video instrumentation and thoracic robotic surgery is rapidly gaining interest. Indeed, robotic surgery pioneers boast the advantages in three-dimensional view, improved magnification, ergonomics, dexterity, safety, and ease of surgery with this technology. This review aims to outline robotic-assisted segmentectomy indications, preoperative evaluation, and the operative conduct for the different lung segments from a single surgeon console. There are many ways to perform segmentectomies and therefore this review describes generalized approaches that can be tailored based on experience.

Keywords: lobectomy; lung cancer; non-small cell lung cancer; robotic-assisted surgery; segmentectomy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Lung segments by Elisabeth Savonitto.
Figure 2
Figure 2
Bronchial tree by Elisabeth Savonitto.
Figure 3
Figure 3
Port placement for robotic segmentectomy by elisabeth savonitto.
Figure 4
Figure 4
Lingulectomy. (A) Dissection of lingular vein. (B) Encircling lingular vein. (C) Dissection of lingular PA branches. (D) Division of lingular bronchus.
See this image and copyright information in PMC

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