Central lung cancer has a complex anatomical location. Sleeve lobectomy and reconstruction is an important surgical method for precise tumor resection, maximum preservation of normal lung tissue, and improvement of postoperative quality of life >.
As one of the high-risk surgeries in thoracic surgery, this procedure is generally only performed in large medical centers, and there are not many sleeve lobectomy performed with the assistance of the Da Vinci robot.
Recently, two patients with central-type lung cancer successfully underwent minimally invasive robotic thoracic surgery in Xiangya Hospital, Central South University. While the tumor was completely and accurately removed, healthy lung tissue was preserved >.
Advanced stage lung cancer has a high recurrence and metastasis rate after treatment, and the surgical resection is difficult, and the conversion to open rate is high, that is, it is less likely to be completed under the minimally invasive incision, and many operations need to significantly extend the surgical incision and require resection The patient has a long rib.
If the surgeon does not have skilled reconstruction techniques and precise resection planning capabilities, many patients will lose the possibility of preserving more lung function, and postoperative breathing will be greatly affected.
The 22-year-old patient Xiao Yang, a college student, was found to have right upper lung carcinoid because of blood in sputum. >, lesions involving the right primary and secondary carina.
Xiao Yang’s parents took him around to seek medical treatment, but he received chemotherapy with poor results.
Traditional surgery requires resection of the whole right lung, and postoperative respiratory function will be seriously affected, and even complications such as respiratory failure may occur, which will seriously affect Xiao Yang’s quality of life in the future.
After coming to the Department of Thoracic Surgery, Xiangya Hospital, Central South University, Director Zhang Chunfang organized discussions in the department, carefully evaluated the surgery before surgery, and formulated a careful surgery plan.
On March 7, Professor Gao Yang and Chief Physician Zhou Yanwu’s surgical team successfully performed robot-assisted right hilar tumor resection and sleeve anastomosis reconstruction for Xiao Yang. While the tumor was removed through the incision, the right middle and lower lung was preserved for Xiao Yang, which laid a solid foundation for his good breathing in the future.
The other patient, Mr. Li, had locally advanced lung cancer when he became symptomatic, and his right upper lung tumor had involved the right main and the upper segment of the right middle bronchus, and there were right hilum and mediastinal lymph node metastasis.
This kind of situation is very difficult, and Professor Gao Yang believes that the patient still has the possibility of surgical resection after careful evaluation.
After standard neoadjuvant therapy, a more precise, minimally invasive and reliable da Vinci robotic surgery was performed for Mr. Li, and the central lung cancer lesion was completely removed and successfully preserved. healthy right middle and lower lung.
Surgical and pathological examination showed that no active cancer cells remained. Mr. Li achieved complete pathological remission and had a good prognosis.
There are only a handful of medical centers in China that can perform this type of surgery with minimally invasive incisions and preserve healthy lung tissue.
At present, the team of Professor Gao Yang from the Department of Thoracic Surgery of Xiangya Hospital, Central South University has routinely carried out the treatment of such advanced lung cancer.
Patients after neoadjuvant therapy usually have fibrosis in the hilar structure, which is difficult to operate and has a high rate of transfer to open. %.
This extremely low ratio is due to the unique advantages of the fourth-generation Da Vinci robotic surgical system.
The endoscopic system of the surgical robot, compared with the traditional thoracoscope, provides 5-10 times magnification of 3D high-definition images, helps the surgeon to judge the spatial distance< /strong>, which is especially important for the delicate manipulation of organs, blood vessels and nerves.
The wrist joint of the robotic device can rotate freely 540 degrees, and the operation in a small space is “a piece of cake”.
With the help of the da Vinci robotic surgery system more precise and smooth operation, less patient bleeding, more rapid recovery.
“We hope that more patients with central lung cancer can be diagnosed and treated by us, and with the help of the robotic surgery system, more operations that were previously difficult to perform by conventional methods become possible, and more patients with lung cancer can benefit. “Professor Gao Yang said.
(Edited by Rainbow.)
Special author of Hunan Medical Chat: Zhou Yanwu, Xiangya Hospital, Central South University