I’m not sure if this should be filed under the Future of Thoracic Surgery – or news, since it won’t be long before more surgeons are performing their surgeries using the DiVinci robot.
I’ve already met a surgeon here in Bogota who has been training to start performing his lung surgeries using this technology.
It’s still a pretty new application of this robot – though reports go back to 2000, but it’s been slow to catch on in this specialty. The Divinci, which has been used for several years; in urology, gynecology and cardiac surgery is an expensive, large, unweldly machine so it takes consider time, and expense to get the necessary training and skills to use it appropriately.
However, one of the surgeons I know in Fresno, at the Stanford Cardiothoracic Surgery Clinic, Dr. Randy Bolton, has been using it for his cardiac cases for years..
So, today, we are looking at the research and case reports related to the use of the Divinci robot for robot-assisted thoracic surgery..
Robotic surgery for mediastinal tumors – Japan: a review of six cases including tomography, diagrams of staff positioning, and a discussion of port placement, as well as some of the problems they encountered (a lack of speciaized instruments).
The University of Illinois experience: 32 cases from 2001 – 2009 ; this study highlights some of the problems implementing new technologies – there is a significant learning curve, and it slows you down.. (The average operating time was 209 minutes). There are some color photos, so caution to the squeamish.
There are three articles pending publication on the use of robotic surgery for thoracic cases – one by Melfi, Vita, Divini and Mussi (European J Cardiothoracic Surgery)
and another, discussing 2 cases of pneumonectomy by robot by Spaggiari and Galetta that sound pretty intriguing.
I’ll see if I can update the article when the articles are more widely available.
Thoracic Surgery 
Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms
J Thorac Cardiovasc Surg 2011;142:740-746
Pulmonary resection using a total endoscopic robotic video-assisted approach.
Semin Thorac Cardiovasc Surg. 2011 Spring;23(1):36-42
Total port-access robot-assisted pulmonary lobectomy without utility thoracotomy.
Eur J Cardiothorac Surg. 2010 Aug;38(2):231-2. Epub 2010 Mar 1
Thanks, Ms. Welch for the updated literature. I’ve posted the links to the abstracts/ articles to the citations provided by Ms. Welch:
Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg. 2011 Oct;142(4):740-6.
Article by Cerfolio et. al. Free full text not available, link to abstract provided.
http://www.ncbi.nlm.nih.gov/pubmed
Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg. 2011 Spring;23(1):36-42. Article by Dylewski et. al. No free text available. Link to abstract:
http://www.semthorcardiovascsurg.com/article/S1043-0679(11)00007-4/abstract
Total port-access robot-assisted pulmonary lobectomy without utility thoracotomy. Eur J Cardiothorac Surg. 2010 Aug;38(2):231-2. Epub 2010 Mar 1
Also Dylewski et. al. No free full text available. Link to abstract:
http://ejcts.oxfordjournals.org/content/38/2/231.abstract