Tunnel technique for robotic-assisted left upper lobectomy

Abstract

Robotic-assisted thoracoscopy is a procedure that allows certain improvements over the traditionally used thoracoscopic procedures but still has disadvantages. Its association with dissection techniques such as the tunnel technique allows an approach to lungs with incomplete or fused fissures. We present the case of a 65-year-old female smoker with a 33-mm mass with a 13.7 SUVmax on positron emission tomography-computed tomography scans accompanied by biopsies that confirmed the diagnosis of small-cell lung cancer. After confirming that it was stage N0 and M0, surgical treatment was chosen. We performed a left upper lobectomy and thoracoscopic lymphadenectomy with robotic assistance; due to the presence of incomplete fissures, we used the fissure tunneling technique. This procedure ensured a safe dissection technique with the correct identification of the vascular and bronchial structures and reduced the risk of air leakage.