Robotic Left Lower Lobectomy With Primary Bronchial Closure and Pleural Flap Coverage for Proximal Carcinoid

Minimally invasive surgical management can be performed safely with R0 resection, utilizing the same technique that would be applied through thoracotomy. The robotic platform provides the surgeon with the opportunity to perform complex procedures with precision, emulating open surgery.

Managing the bronchus minimally invasively without compromising the margin and without complication requires that the surgeon use bronchial management techniques such as sharp division and suture closure, which have been replaced by endoscopic staplers. Knowledge of this traditional approach is essential to address cases that would otherwise be performed through thoracotomy, as these techniques are not commonly performed with minimally invasive techniques.

Suggested Reading

1. Filosso PL, Rena O, Donati G, et al. Bronchial carcinoid tumors: surgical management and long-term outcome. J Thorac Cardiovasc Surg. 2002;123(2):303-309.
2. Detterbeck FC. Management of carcinoid tumors. Ann Thorac Surg. 2010;89(3):998-1005.
3. Vester SR, Faber LP, Kittle CF, Warren WH, Jensik RJ. Bronchopleural fistula after stapled closure of bronchus. Ann Thorac Surg. 1991;52(6):1253-1258.