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  • Title
  • 1. Introduction
  • 2. Bronchoscopy
  • 3. Patient Setup
  • 4. Placement of Ports
  • 5. Robot Docking
  • 6. Mediastinal Lymph Node Dissection
  • 7. Middle Lobectomy
  • 8. Hemostasis
  • 9. Specimen Extraction and Robot Undocking
  • 10. Gross Examination of Specimen
  • 11. Closure
  • 12. Post-op Remarks

Robotic Right Middle Lobectomy and Mediastinal Lymph Node Dissection for Adenocarcinoma

742 views

Hugh G. Auchincloss, MD, MPH
Massachusetts General Hospital

Thoracic Surgery

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Bronchoscopy
      1. 3. Patient Setup
        1. 4. Placement of Ports
          1. 5. Robot Docking
            1. 6. Mediastinal Lymph Node Dissection
              1. 7. Middle Lobectomy
                1. 8. Hemostasis
                  1. 9. Specimen Extraction and Robot Undocking
                    1. 10. Gross Examination of Specimen
                      1. 11. Closure
                        1. 12. Post-op Remarks
                          1. Rule Out Obvious Metastasis
                          2. Take Down any Adhesions
                          3. Take Down Inferior Pulmonary Ligament and Resect Inferior Pulmonary Hilar Lymph Nodes
                          4. Posterior Hilum and Subcarinal Lymph Nodes
                          5. Superior Hilum and Right Paratracheal Nodes
                          1. Anterior Hilum and Venous Anatomy
                          2. Major Fissure and Middle Lobe Bronchus
                          3. Further Lymph Node Dissection to Elucidate Anatomy
                          4. Division of Middle Lobe Vein
                          5. Isolation and Division of Middle Lobe Bronchus
                          6. Isolation and Division of Middle Lobe Pulmonary Artery Branch
                          7. Parenchymal Division of Upper Lobe Wedge Near Margin
                          8. Parenchymal Division Along Pulmonary Artery for Better Margin
                          9. Use ICG to Visualize the Minor Fissure
                          10. Parenchymal Division at Minor Fissure to Complete Resection

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                          Authors

                          Filmed At:

                          Massachusetts General Hospital

                          Article Information

                          Publication Date
                          Article ID420
                          Production ID0420
                          Volume2025
                          Issue420
                          DOI
                          https://doi.org/10.24296/jomi/420