Complex Robotic-Assisted Right Lower Lobe Basilar Segmentectomy in the Setting of Prior Laryngectomy

Introduction

Operating in a post-surgical field has inherent technical challenges. Often, tissue preservation is important because prior excision can leave the remaining anatomy limited. In select cases, the enhanced abilities afforded by robotic-assisted surgery allow for critical tissue preservation compared to standard laparoscopic techniques.

Methods

A 76-year-old male presented with an incidentally found and enlarging hyper-metabolic 2.2 cm right lower lobe nodule. He had a pertinent history of laryngectomy for proven squamous cell carcinoma of the supraglottis. Following preoperative clearances, he was booked for elective robotic-assisted pulmonary resection.

Results

Use of robotic minimally invasive surgery allowed for clear delineation of structures and the dissection required for tissue-sparing resection in the post-operative surgical field. The procedure was completed without complication and without the need for lobectomy as may have been required otherwise. The patient was discharged home on post-operative day two in good condition. Surgical pathology showed moderately differentiated squamous cell carcinoma.

Conclusions

The use of robotic technology allows for technical advancement within the field of minimally invasive surgery, making possible tissue-preserving procedures like those demonstrated in the video. These procedures are critical in certain instances, such as the post-operative surgical field in the patient scenario discussed. We hope that the information demonstrated in this video will contribute to the overall improvement of technical ability in the field of complex pulmonary surgery.

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