Thoracic surgery is done on the chest, but it does not involve surgery on the heart. With robot-assisted thoracic procedures, the doctor guides small robotic arms through keyhole incisions.
Robot-assisted thoracic procedures are considered for surgeries that:
Some thoracic surgeries that have been successfully performed using robotic techniques include:
Compared to more traditional procedures, robotic-assisted surgery may result in:
Complications are rare, but no procedure is completely free of risk. If you are planning to have a robot-assisted thoracic procedure, your doctor will review a list of possible complications, which may include:
Some factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before the procedure.
Depending on the reason for your surgery, your doctor may do the following:
Leading up to the procedure:
General anesthesia will be used. It will block any pain and keep you asleep through the surgery.
You will be connected to a ventilator. This is a machine that moves air in and out of your lungs. Next, the doctor will cut several keyhole openings in the chest wall between the ribs. One or more chest tubes may be placed into the side of the chest. These tubes will be used to drain fluid and monitor air leakage. A needle may be used to inject carbon dioxide gas into the chest cavity. The gas will make it easier for the doctor to see internal structures.
The doctor will then pass a small camera, called an endoscope, through one of the incisions. The camera will light, magnify, and project the structures onto a video screen. The camera will be attached to one of the robotic arms. The other arms will hold instruments for grasping, cutting, dissecting, and suturing. These may include:
While sitting at a console near the operating table, the doctor will look through lenses at magnified 3D images of the inside of the body. Another doctor will stay by the table to adjust the camera and tools. With joystick-like controls and foot pedals, the doctor will guide the robotic arms and tools to remove organs and tissue. After the tools are removed, the doctor will use sutures or staples to close the surgical area.
If you are doing well, the breathing tube will be removed. Later, the chest tubes will be removed.
About 1-4 hours (depending on the procedure)
You will have pain during recovery. Your doctor will give you pain medicine. You may also feel discomfort from the gas used during the procedure. This can last up to three days.
This procedure is done in a hospital setting. The usual length of stay is a few days. Your doctor may choose to keep you longer if you have any problems.
While you are recovering at the hospital, you may receive the following care:
When you return home, do the following to help ensure a smooth recovery:
Depending on the procedure, you should recover within a few weeks.
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, CALL 911.
RESOURCES:
American College of Surgeons
http://www.facs.org/
Society of Thoracic doctors
http://www.sts.org/
CANADIAN RESOURCES:
Canadian Agency for Drugs and Technologies in Health
http://www.cadth.ca/
Canadian Lung Association
http://www.lung.ca/
References:
Esophageal cancer—esophagectomy. University of Maryland Medical Center website. Available at: http://www.umm.edu/thoracic/esoph_surgery.html. Accessed July 21, 2006.
Rea F, Marulli G, Bortolotti L. Robotic video-assisted thoracoscopic thymectomy. Multimedia Manual of Cardiothoracic Surgery website. Available at: http://mmcts.ctsnetjournals.org/cgi/content/full/2005/0324/mmcts.2004.000422. Published March 24, 2005. Accessed July 21, 2006.
Sympathectomy. New York Presbyterian Hospital website. Available at: http://www.nyp.org/health/sympathectomy.html. Accessed May 5, 2008.
Thoracic applications. Intuitive Surgical website. Available at: http://www.intuitivesurgical.com/clinical/thoracicapplications/index.aspx. Accessed July 21, 2006.
Thoracic lobectomy. New York-Presbyterian Hospital website. Available at: http://www.nyp.org/masc/lobectomy.htm. Accessed September 16, 2009.
Thymectomy. Myasthenia Gravis Foundation of America website. Available at: http://www.myasthenia.org/information/thymectomy.htm. Accessed July 21, 2006.
Last reviewed December 2009 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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