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Ann Thorac Surg 2004;78:259-265
© 2004 The Society of Thoracic Surgeons

Original article: general thoracic

Early experience with robot-assisted surgery for mediastinal masses

Johannes Bodner, MDa, Heinz Wykypiel, MDa, Andreas Greiner, MDb, Werner Kirchmayr, MDa, Martin C. Freund, MDc, Raimund Margreiter, MDa, Thomas Schmid, MDa*

a Department of General and Transplant Surgery, Innsbruck University Hospital, Innsbruck, Austria
b Department of Vascular Surgery, Innsbruck University Hospital, Innsbruck, Austria
c Radiology, Innsbruck University Hospital, Innsbruck, Austria

Accepted for publication February 3, 2004.

* Address reprint requests to Dr Schmid, Department of General and Transplant Surgery, Innsbruck University Hospital, Anichstrasse 35, A-6020 Innsbruck, Austria
e-mail: thomas.schmid{at}uklibk.ac.at

BACKGROUND: We report the experience of a single institution with the minimally invasive resection of mediastinal masses using the da Vinci robotic surgical system.

METHODS: From August 2001 to June 2003, 14 patients (5 men and 9 women aged from 21 to 77 years) with mediastinal masses were operated on minimally invasively with the da Vinci robotic system. This consisted of 9 thymectomies (6 thymomas, 2 nonatrophic thymic glands, 1 thymic cyst), 3 resections of paravertebral neurinomas, 1 ectopic mediastinal parathyroidectomy, and 1 resection of a lymphangioma.

RESULTS: Complete, extended thymectomy was accomplished in all 9 cases, proven by examination of the thymic bed and resected specimen. In 1 patient with an hourglass-shaped neurinoma, conversion to an open procedure was necessary because the excessive size of the tumor limited vision. The median overall operation time was 166 minutes (range, 61 to 182) including 110 minutes (range, 46 to 142) for the robotic act. There were no intraoperative complications or surgical mortality.

CONCLUSIONS: These preliminary results of our series suggest that application of the da Vinci robotic surgical system for resection of selected mediastinal masses is technically feasible and safe. It provides an alternative to open approaches and "conventional" thoracoscopy. Nevertheless, this new technique requires further investigation in larger series and longer follow-up.




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