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Eur J Cardiothorac Surg 2003;23:883-887
© 2003 Elsevier Science NL

Advanced thoracoscopic procedures are facilitated by computer-aided robotic technology

Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA

Received 11 December 2002; received in revised form 5 March 2003; accepted 7 March 2003.

^* Corresponding author. Tel.: +1-212-305-5108; fax: +1-212-305-2439
e-mail: jm2240{at}columbia.edu

Objective: Computer (robotic) enhancement has been used to facilitate simple thoracoscopic procedures such as internal mammary artery (IMA) mobilization. This report describes the use of robotic technology in advanced thoracoscopic procedures. Methods: Ten patients underwent advanced thoracoscopic procedures utilizing the Da Vinci robotic surgical system (Intuitive Surgical, Mountain View, CA) at our institution. Results: Patients 1–6 underwent endoscopic phrenic nerve mobilization with insertion of phrenic nerve pacemakers. The indications were quadriplegia (n=2), central hypoventilation syndrome (n=2), and intractable hiccups (n=2). Three 1-cm incisions were made to access each hemithorax. Patients 7 and 8 underwent robotically assisted resection of posterior mediastinal masses. Patient 9 underwent robotically assisted thoracoscopic left lower lobectomy for a lung mass. Patient 10 underwent robotically assisted left ventricular lead placement for biventricular pacing for heart failure. Conclusions: Robotic technology can be used to perform advanced intrathoracic maneuvers thoracoscopically. The increased visualization and instrument dexterity afforded by this technology may facilitate the development of minimally invasive thoracic approaches that were previously not feasible.

Key Words: Advanced thoracoscopic procedure • Robotic system

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