The Robotic Surgery Center at NYU Langone Medical Center has added robot-assisted lobectomy (lung resection) to its growing list of robotic procedures. In this operation for early-stage lung cancer, the surgeon uses the da Vinci Si surgical robot’s miniaturized instruments and camera to remove the entire affected lobe of the lung along with adjacent lymph nodes, all through a series of small incisions in the chest.
Until just a few years ago, lobectomies could only be performed through open surgery—an operation that employs a large open incision and a mechanical rib spreader, resulting in considerable post-operative pain and a lengthy recovery. In robotic surgery, the entire procedure is done using five quarter-inch incisions, with no trauma to the rib cage. As a result, patients experience minimal post-operative discomfort, significantly faster recovery, and shorter hospital stays.
The newly added procedure is one of a number of thoracic operations now being done robotically at NYU Langone. “We believe in offering patients the newest, least invasive techniques as they evolve, and we look forward to expanding these robotic techniques, when possible, to all cases involving the mediastinum, lung, and esophagus,” says Dr. Harvey Pass, the Medical Center’s Division Chief for Thoracic Surgery.
NYU Langone’s Department of Cardiothoracic Surgery, which also helped pioneer endoscopic lobectomies using a technique called video-assisted thoracic surgery (VATS), is one of the few surgery departments nationwide to offer robot-assisted lobectomies. “Robotic surgery is the natural next step in the evolution of this procedure,” says Dr. Michael Zervos, who performed the Robotic Surgery Center’s first-ever robotic lobectomy in May of this year. “It provides the same minimally-invasive benefits that VATS does, but it also has some clear advantages over the VATS approach. For example, the robot’s high-definition, three-dimensional camera gives an excellent view of the small spaces in the chest, which really facilitates removal of the lymph nodes.”
Since introducing the technique to the Medical Center, Dr. Zervos has gone on to perform the robotic procedure multiple times. His Robotic Surgery Center colleagues, Dr. Costas Bizekis and Dr. Pass will also be performing robotic lobectomies in the future.
“Eventually, I think most lung resections that are amenable to this approach will be done robotically,” says Dr. Zervos. Among other things, he notes, the da Vinci’s precise finger tip controls, which simulate the motions a surgeon makes during open surgery, are ideal for carrying out the delicate movements inside the confined chest cavity that a lobectomy requires. “With VATS, you’re going through the chest wall using straight instruments with limited maneuverability,” he explains. “The da Vinci Si, with its tremendous wrist action, lets me move in many different directions in a tight space, giving me more flexibility and options.”
While VATS and open surgery will continue to have a role in lung surgery, adds Dr. Zervos, “I feel very good about doing lung resections using the robot. I think it’s a very safe approach, and one that patients will benefit from. In fact, I plan on doing all my lung resections this way going forward.”