Robotic Left Upper Lobectomy With Situs Inversus

This video demonstrates a robotic left upper lobectomy in a woman with a history of smoking, COPD, and breast cancer treated with surgery and adjuvant radiotherapy-hormone therapy. The particularity of this patient is that she presented with complete situs inversus (three lobes and two pulmonary fissures as in a right-sided lung). 

She had a suspicious 28-millimeter nodule in the left upper lobe, and after a multidisciplinary discussion, it was concluded that it was necessary to perform a left upper lobectomy. 

The preoperative plan was to place the four robotic arms and the assistant port for a left upper lobectomy, but the dissection was performed using the clockwise technique in a five-step procedure as for a right upper lobectomy. First, by liberating the pulmonary ligament and then following the described dissection scheme.  

The chest tube was removed after one day and the patient was discharged after nine days due to postoperative pneumonia in the middle lobe. 

The one-month follow-up consultation showed no pneumothorax and no pleural effusion. The patient was not complaining of any pain or dyspnea. 

References

1. Bouabdallah I.,Doddoli C.,Trousse D.,Brioude G.,Rivera C.,Thomas P.-A.,D’Journo X.-B., Techniques d’exérèses pulmonaires lobaires robot-assistées, Techniques chirurgicales - Thorax, Volume 38, Issue 4, 2021, Pages 1-9, ISSN 1241-8226, http://dx.doi.org/10.1016/S1241-8226(21)83412-X

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