Early experience and learning curve of anatomatic lung resection by robotic-assisted thoracoscopic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TANG Jian ,  YU Bentong , LIU Sheng , XU Qirong , YUAN Bin , LIU Jichun

Department of Cardiathoracic Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, P.R.China;

Corresponding author：

YU Bentong, Email: yubentong@126.com

Keywords：

Anatomatic lung resection; robot-assisted thoracoscopic surgery; learning curve; da Vinci surgical system

DOI：

10.7507/1007-4848.201607008

Video：

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ObjectiveTo summarize the surgical learning curve and evaluate the effectiveness, safety and feasibility of the robotic-assisted thoracoscopic surgery (RATS) by comparing with the conventional vedio-assisted thoracoscopic surgery (VATS).MethodsThe clinical data of 40 patients receiving robotic assisted thoracoscopic anatomic lung resection from March to June 2016 in our department were reviewed. There were 29 males and 11 females with the age of 54-78 (60.2±12.7) years in the RATS group, and 27 males and 10 females with the age of 52-76 (58.7±11.5) years in the VATS group. Lung space-occupying lesions were comfirmed by preoperative diagnosis. The operative time, blood loss, chest tube retention time, postoperative hospital stay and perioperative morbidity and mortality were analyzed. The safety and feasibility were evaluated, and the learning curve was summed up.ResultsOperative time, postoperative ventilation time, intraoperative blood loss, chest tube retention time, postoperative pain, average hospital stay, postoperative complication rate between two groups were not statistically significant. In the RATS group preoperative preparation time was longer than that of the VATS group (24.5 min vs. 15.6 min, P=0.003), and the rate of conversion to thoracotomy of the RATS group was lower than that of the VATS group (0 vs. 10.8%). There was no perioperative death in two groups.ConclusionRobotic-assisted thoracic surgery is safe and effective in the early learning process, and the learning curve can be entered into the standard stage from the learning stage after initial 10 operations.

Citation： TANG Jian, YU Bentong, LIU Sheng, XU Qirong, YUAN Bin, LIU Jichun. Early experience and learning curve of anatomatic lung resection by robotic-assisted thoracoscopic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(7): 533-537. doi: 10.7507/1007-4848.201607008 Copy

1.	Mckenna RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1, 100 cases. Ann Thorac Surg, 2006, 81(2): 421-426.
2.	范盛浩, 葛建明, 谢廷洪, 等. 电视胸腔镜与传统开胸肺叶切除术治疗原发性非小细胞肺癌. 中国胸心血管外科临床杂志, 2009, 16(6): 449-453.
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4.	杨帆, 李晓, 王俊, 等. 连续 300 例全胸腔镜肺叶切除术及中期随访分析. 中国胸心血管外科临床杂志, 2011(02): 95-98.
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8.	王述民, 汪诚风. 浅谈达芬奇机器人手术系统与电视胸腔镜系统在胸外科肺叶切除术中优劣. 临床军医杂志, 2016, 44(6): 551-555.
9.	丁仁泉, 童向东, 许世广, 等. 达芬奇机器人手术系统与电视胸腔镜在胸内纵隔疾病手术治疗中的对比研究. 中国肺癌杂志. 2014, 17(7): 557-562.
10.	Park BJ, Melfi F, Mussi A, et al. Robotic lobectomy for non-small cell lung cancer (NSCLC): Long-term oncologic results. J Thorac Cardiovasc Surg, 2012, 143(2): 383-389.
11.	Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
12.	Melfi FM, Menconi GF, Mariani AM, et al. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
13.	Zhang L, Gao S. Robot-assisted thoracic surgery versus open thoracic surgery for lung cancer: a system review and meta-analysis. Int J Clin Exp Med, 2015, 8(10): 17804-17810.
14.	Demir A, Ayalp K, Ozkan B, et al. Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions. Interact Cardiovasc Thorac Surg, 2015, 20(3): 304-309.
15.	Veronesi G, Agoglia B G, Melfi F, et al. Experience with robotic lobectomy for lung cancer. Innovations (Phila), 2011, 6(6): 355-360.
16.	Meyer M, Gharagozloo F, Tempesta B, et al. The learning curve of robotic lobectomy[J]. Int J Med Robot, 2012, 8(4): 448-452.
17.	Toker A, Ozyurtkan M O, Kaba E, et al. Robotic anatomic lung resections: the initial experience and description of learning in 102 cases. Surg Endosc, 2016, 30(2): 676-683.

1. Mckenna RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1, 100 cases. Ann Thorac Surg, 2006, 81(2): 421-426.
2. 范盛浩, 葛建明, 谢廷洪, 等. 电视胸腔镜与传统开胸肺叶切除术治疗原发性非小细胞肺癌. 中国胸心血管外科临床杂志, 2009, 16(6): 449-453.
3. 李剑锋, 杨帆, 李运, 等. 连续 100 例全胸腔镜下肺叶切除术的临床分析. 中国胸心血管外科临床杂志, 2009, 16(1): 1-5.
4. 杨帆, 李晓, 王俊, 等. 连续 300 例全胸腔镜肺叶切除术及中期随访分析. 中国胸心血管外科临床杂志, 2011(02): 95-98.
5. 田界勇, 马冬春, 徐美清, 等. 全胸腔镜肺叶切除术治疗周围型肺癌的临床分析. 中国胸心血管外科临床杂志, 2012, 19(5): 479-483.
6. Ambrogi MC, Fanucchi O, Melfi F, et al. Robotic surgery for lung cancer. Korean J Thorac Cardiovasc Surg, 2014, 47(3): 201-210.
7. 蒲强, 马林, 车国卫, 等. 单向式胸腔镜肺叶切除安全性及技术可行性研究——附 1 040 例报告. 四川大学学报(医学版), 2013, 44(1): 109-113.
8. 王述民, 汪诚风. 浅谈达芬奇机器人手术系统与电视胸腔镜系统在胸外科肺叶切除术中优劣. 临床军医杂志, 2016, 44(6): 551-555.
9. 丁仁泉, 童向东, 许世广, 等. 达芬奇机器人手术系统与电视胸腔镜在胸内纵隔疾病手术治疗中的对比研究. 中国肺癌杂志. 2014, 17(7): 557-562.
10. Park BJ, Melfi F, Mussi A, et al. Robotic lobectomy for non-small cell lung cancer (NSCLC): Long-term oncologic results. J Thorac Cardiovasc Surg, 2012, 143(2): 383-389.
11. Cerfolio RJ, Bryant AS, Skylizard L, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg, 2011, 142(4): 740-746.
12. Melfi FM, Menconi GF, Mariani AM, et al. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg, 2002, 21(5): 864-868.
13. Zhang L, Gao S. Robot-assisted thoracic surgery versus open thoracic surgery for lung cancer: a system review and meta-analysis. Int J Clin Exp Med, 2015, 8(10): 17804-17810.
14. Demir A, Ayalp K, Ozkan B, et al. Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions. Interact Cardiovasc Thorac Surg, 2015, 20(3): 304-309.
15. Veronesi G, Agoglia B G, Melfi F, et al. Experience with robotic lobectomy for lung cancer. Innovations (Phila), 2011, 6(6): 355-360.
16. Meyer M, Gharagozloo F, Tempesta B, et al. The learning curve of robotic lobectomy[J]. Int J Med Robot, 2012, 8(4): 448-452.
17. Toker A, Ozyurtkan M O, Kaba E, et al. Robotic anatomic lung resections: the initial experience and description of learning in 102 cases. Surg Endosc, 2016, 30(2): 676-683.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Early experience and learning curve of anatomatic lung resection by robotic-assisted thoracoscopic surgery

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