Robotic XI Four-Arm Total Port Video-Assisted Left Pneumonectomy

The procedure illustrated in this video was performed for a 67-year-old female nonsmoker who presented with hemolysis and a cough. She was found to have a 5 cm centrally-located clinical T2N0MX stage IB carcinoid tumor of the left lung.

Suggested Reading

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3. Dylewski MR, Lazzaro RS. Robotics – The answer to the Achilles’ heel of VATS pulmonary resection. Chin J Cancer Res. 2012;24(4):259-260.
4. Dylewski MR, Lazzaro R, Abbas AE. Complete port-access robotic-assisted lobectomy utilizing three-arm technique without a transthoracic utility incision. In: Kim KC, ed. Robotics in General Surgery. New York, NY: Springer; 2014:69-84.
5. Veronesi G, Galetta D, Maisonneuve P, et al. Four-arm lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg. 2010;140(1):19-25.
6. Melfi FM, Menconi GF, Mariani AM, Angeletti CA. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg. 2002;21(5):864-868.
7. Park BJ, Flores RM, Rusch VW. Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results. J Thorac Cardiovasc Surg. 2006;131(1):54-59.
8. Gharagozloo F, Margolis M, Tempesta B. Robot-assisted thoracoscopic lobectomy for early-stage lung cancer. Ann Thorac Surg. 2008;85(6):1880-1886.
9. Dylewski MR, Ohaeto AC, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg. 2011;23(1):36-42.
10. Gharagozloo F, Margolis M, Tempesta B, Strother E, Najam F. Robot-assisted lobectomy for early-stage lung cancer: report of 100 consecutive cases. Ann Thorac Surg. 2009;88(2):380-384.
11. Park BJ, Flores RM. Cost comparison of robotic, video-assisted thoracic surgery and thoracotomy approaches to pulmonary lobectomy. Thorac Surg Clin. 2008;18(3):297-300.

Dr Dylewski is a clinical educator for Intuitive Surgical and Verb Surgical.