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Robot-Assisted Thoracic Procedures

Definition

A robot-assisted thoracic surgery is when a doctor guides small robotic arms through tiny incisions to do surgery inside the chest but not on the heart. It allows for greater range of motion than regular surgery.

Reasons for Procedure

This method is used when surgery needs to be precise. Examples of robot-assisted thoracic surgeries are:

  • Thymectomy —removal of the thymus gland
  • Lobectomy —removal of a lung lobe
  • Esophagectomy —removal of the esophagus
  • Mediastinal tumor resection —removal of tumors located in the part of the chest cavity that separates the lungs
  • Sympathectomy—cauterizing a portion of the sympathetic nerve

The benefits of this type of surgery are:

  • Less blood loss
  • Lower risk of infection
  • Less scarring
  • Less trauma to the body
  • Faster recovery
  • Less time in the hospital

Possible Complications

Problems from robotic-assisted surgeries are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Collection of air or gases in the lung cavity
  • Collapsed lung
  • Damage to nearby organs or structures
  • The need to switch to traditional surgery types, such as traditional laparoscopic or open surgery

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging for a ride to and from surgery
  • Tests that will need to be done before surgery, such as imaging tests

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure

You will be connected to a machine that will help you breathe. Several small incisions will be made between the ribs. Tubes may be placed into the side of the chest. They will help drain fluid and check for air leaking. A needle may be used to inject gas into the chest cavity. This will make it easier to see inside the body. A scope with a small camera on the end will be passed through one of the incisions. The camera will display the area on a video screen. Next, robotic arms holding tools will be inserted through the holes.

While sitting nearby, the doctor will use lenses to look at a magnified 3-D image of the inside of the body. Another doctor will adjust the camera and tools. The robotic arms and tools will be guided by the surgeon. When the surgery is done, the tools will be removed. Stitches or staples will be used to close the incisions. Bandages will be used to cover them.

How Long Will It Take?

About 1 to 4 hours. It depends on the type of surgery.

Will It Hurt?

It depends on the surgery, but pain and swelling are common in the first 2 weeks. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is a few days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Care Center

Right after the procedure, the staff may:

  • Give you medicine to treat pain
  • Teach you how to do deep breathing and coughing exercises

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

You can also lower your chance of infection by:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

Activities will be limited during recovery. You may need to ask for help with daily activities and delay your return to work. It will take a few weeks to heal.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision
  • Been coughing up yellow, green, or bloody mucus
  • Cough or shortness of breath
  • New chest pain
  • Pain and/or swelling in your feet, calves, or legs
  • New or unexpected symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Thoracic Society
https://www.thoracic.org

The Society of Thoracic Surgeons
https://www.sts.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Lung Association
https://www.lung.ca

REFERENCES:

Robotic surgery. The Robotic Surgery Center at NYU Langone Medical Center website. Available at: http://robotic-surgery.med.nyu.edu/for-patients/what-robotic-surgery. Accessed August 14, 2020.

Robotic thoracic surgery. UCSF Department of Surgery website. Available at: https://surgery.ucsf.edu/conditions--procedures/robotic-thoracic-surgery.aspx. Accessed August 17, 2020.

Last reviewed March 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 8/17/2020