Robotic-Assisted Thoracoscopic Right Upper Lobe Posteroapical Segmentectomy
Andrew Akcelik, Maruti Kumaran, Charles Bakhos, Abbas Abbas, Roman Petrov.
Temple University Hospital, Philadelphia, PA, USA.
OBJECTIVE: With the advancement of imaging modalities, incidental pulmonary nodules have become increasingly more common. Approximately 150,000 nodules per year are detected in the United states. Tobacco smoking is the greatest risk factor. Solid nodules 8 mm and greater in size have a high cancer probability of 9.7%, per literature, with part-solid nodules having an especially high risk of malignancy. Segmentectomy has been shown to be oncologically equivalent to lobectomy for small nodules.
METHODS: In this video, we describe the case of a 57-year-old male, current smoker, who had an incidental 2 cm right upper lobe part-solid pulmonary nodule. From our recordings in the operating room, we will demonstrate our operative technique with added narration. We will also describe the postoperative course and pathologic findings, with the nodule proving to be adenocarcinoma.
RESULTS: The pulmonary nodule proved to be adenocarcinoma, with negative resection margins. Additionally, all of the 12 lymph nodes harvested were negative for malignancy.
CONCLUSIONS: Segmentectomy has been shown to be oncologically equivalent to lobectomy for small nodules. Here, we have demonstrated that robotic assisted-thoracoscopic surgery enables parenchymal-sparing anatomic lung resection.
 Loverdos K, Fotiadis A, Kontogianni C, Iliopoulou M, Gaga M. Lung nodules: A comprehensive review on current approach and management. Ann Thorac Med. 2019;14(4):226-238. doi:10.4103/atm.ATM_110_19
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