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Ann Thorac Surg 2005;79:450-455
© 2005 The Society of Thoracic Surgeons

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Original article: General thoracic

Application of Robotic-Assisted Techniques to the Surgical Evaluation and Treatment of the Anterior Mediastinum

Providence St. Vincent Heart and Vascular Institute, Portland, Oregon

Accepted for publication July 14, 2004.

^* Address reprint requests to Dr Savitt, Providence St. Vincent Heart and Vascular Institute, 9155 SW Barnes Rd, Suite 240, Portland, OR97225 (E-mail: msavitt{at}starrwood.com).

BACKGROUND: We report our initial experience with the application of robotic-assisted technologies to the treatment of diseases of the anterior mediastinum.

METHODS: Between October 2001 and December 2003, 18 consecutive patients with anterior mediastinal masses were referred for diagnosis and treatment. Fifteen patients underwent robotic-assisted surgery with the da Vinci robotic system. A single surgical team performed all operations. Resection was accomplished by either median sternotomy or robotic-assisted techniques.

RESULTS: Fourteen patients underwent successful robotic-assisted thymectomy. One patient underwent robotic-assisted biopsy of a mass that was later determined to be a poorly differentiated carcinoma, 3 patients underwent complete thymectomy by median sternotomy for biopsy-proven extracapsular thymoma, 7 patients had thymoma, and 3 had myasthenia gravis. There were 2 patients each with benign thymic cysts and thymic hyperplasia. Primary thymic carcinoid, thymolipoma, papillary thyroid cancer, and poorly differentiated carcinoma were present in 1 patient each. No conversions, intraoperative complications, or deaths occurred in the 15 patients who underwent robotic-assisted resection. The mean operative time was 96 minutes (range 62 to 132 minutes). The mean robotic time was 48 minutes (range 22 to 76). The median hospital stay was 2 days. All patients are doing well, with a median follow-up of 1 year.

CONCLUSIONS: Robotic-assisted surgery of the anterior mediastinum, and particularly thymectomy, can be performed safely and efficiently. The increased visualization and instrument dexterity afforded by this technology provides an optimal minimally invasive approach to the anterior mediastinum. From this experience we have formulated a comprehensive treatment algorithm for the surgical evaluation and treatment of patients with anterior mediastinal diseases.

This article has been cited by other articles:

				F. Augustin, T. Schmid, M. Sieb, P. Lucciarini, and J. Bodner Video-Assisted Thoracoscopic Surgery versus Robotic-Assisted Thoracoscopic Surgery Thymectomy Ann. Thorac. Surg., February 1, 2008; 85(2): S768 - S771. [Full Text] [PDF]

				F. Rea, G. Marulli, L. Bortolotti, P. Feltracco, A. Zuin, and F. Sartori Experience With the "Da Vinci" Robotic System for Thymectomy in Patients With Myasthenia Gravis: Report of 33 Cases Ann. Thorac. Surg., February 1, 2006; 81(2): 455 - 459. [Abstract] [Full Text] [PDF]