This procedure, known as port access robotic lobectomy, requires only small incisions which are less painful and offers faster recovery times than more standard operations for lung cancer. BMC was the first hospital in New England to perform robotic operations for thoracic diseases such as lung cancer.
Although surgeons have been performing lung cancer resections using video-assisted thoracic surgery (VATS) for more than a decade, using a robot for the procedure is a relatively new development.
Traditionally lung cancer resections have been done via an open incision or thoracotomy. This incision can be painful because it involves cutting through muscle and spreading the ribs. According to the surgeons, if pain following surgery is not adequately managed, patients may face an increased risk of developing pneumonia as they can find it difficult to cough and clear their lungs of secretions.
Thoracic surgeons at BMC have been performing VATS resections for lung cancer for several years. VATS was a marked improvement over earlier techniques because it requires only two to three small incisions to the chest and an additional four to six centimeter incision for instrument access. “However, the next step in the evolution of minimally invasive lung cancer is the use of the robot,” said Hiran Fernando, MBBS, FRCS, director of BMC’s Minimally Invasive Thoracic Surgery Program as well as director of the Center for Minimally Invasive Esophageal Therapies. “We believe that the robot may have an even greater advantage over VATS for patients undergoing lung cancer surgery,” added Fernando, who is an associate professor of cardiothoracic surgery at Boston University School of Medicine (BUSM).
Traditional VATS instruments allow only up and down (or open and close) movements and some limited rotation,” explained Michael Ebright, MD, co-director of BMC’s Lung Cancer Cyberknife program and an assistant professor of cardiothoracic surgery at BUSM. “Robotic instruments allow several more degrees of freedom of movement thus mimicking the complex combinations of up/down and rotation of the hand and wrist. Additionally, these movements occur directly inside the chest cavity rather than at the ribs. According to Ebright this approach minimizes pressure on the nerves that run along each rib and may result in decreased post-operative pain.
In addition to using a robotic approach to remove lung cancer, BMC surgeons are also treating some esophageal and mediastinal diseases. The robot is especially useful for myasthenia gravis, where the traditional approach requires splitting the sternal bone to get access to the thymus gland which lies beneath the sternum and over the heart. With the robot, only four small incisions are now required in the soft tissue without any need for dividing boney structures.
For more information, please visit www.bostonthoracicsurgery.com
Boston Medical Center is a private, not-for-profit, 639-licensed bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet—15 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit www.bmc.org.
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