ROBOT SURGEY AND MINIMALLY INVASIVE TREATMENT FOR LUNG CANCER
|
|
- Sylvia Douglas
- 6 years ago
- Views:
Transcription
1 ROBOT SURGEY AND MINIMALLY INVASIVE TREATMENT FOR LUNG CANCER Giulia Veronesi European Institute of Oncology Milan Lucerne, Samo 24 th - 25 th January, 2014
2 DIAGNOSTIC REVOLUTION FOR LUNG CANCER - Imaging advancement and early detection programs > more than 80% stage I and II - Less invasive treatment - Modern medicine: from the maximum tolerable treatment to the minimum effective treatment Stage of screening detected lung cancers COSMOS STUDY 17; 13% 7; 5% 9; 7% 95; 75% I II III IV
3 IMPROVEMENT OF DIAGNOSTIC TOOLS (SCREENING) = EVOLUTION OF SURGICAL TREATMENT Posterolateral Thoracotomy Lateral Muscle Sparing Thoracotomy VATS Approach Robotic Approach
4
5 VATS LOBECTOMY - Introduction of the minimally invasive approach marks one of the great advances in surgery and the advantages of VATS lobectomy are well accepted - Shortcomings: - limited visual information - limited freedom of movement - poor ergonomics - Challenge for surgeons and potential danger for patients - Significant learning curve to develop and maintain advanced skills The majority of advanced thoracoscopic cases are performed by a small number of surgeons
6 ROBOTIC SYSTEM Advantages: To overcome vats limitations, micromechanic and robotic technology was introduced in the mid Natural movements of the surgeon s hands are traslated into precise instrument movements inside the patient with tremor filtration. Three dimensional view offers a visual magnification that compensate the absence of haptic feedback Robotic system can made advanced thoracoscopic surgery accessible to surgeons who do not have advanced videoendoscopic training. Expand indications. Advantages for patients.
7 ROBOT vs. CONVENTIONAL VIDEOSURGERY INSTRUMENTS: ADVANTAGES AND DISADVANTAGES ADVANTAGES 1. Intuitive movements 2. Tremor filtration 3. Increased degrees of freedom 4. Motion scaling 5. Stereoscopic vision 6. Stable camera platform 7. Equivalence between the dominant and non-dominant hands 8. Motion analysis 9. Eye-hand-target alignment 10. Possibly shorter learning curve DISADVANTAGES 1. Costs 2. Loss of tactile feedback 3. Limited instrumentation available 4. Significant system set-up time 5. Need of at least one experienced assistant 6. Possible delayed response by the surgeon in case of catastrophic event As every evolving technology, robotic has many limitations, however entrance of competitor companies into the market and extended use of the robot will reduce costs
8 ROBOTIC LOBECTOMIES: CASE SERIES Lead Author Year No. Pts MOT LOS Compl. Mortality Conversion (min) (Days) (%) (%) RAL Park Melfi na 1 na Gharagozloo Veronesi Park, Melfi, Veronesi na 8 Veronesi CPRL / CPRS Dylewski / Cerfolio / CPRL Complete port robotic lobectomy CPRS Complete port robotic segmentectomy RAL Robotic assisted lobectomy
9 ROBOTIC LOBECTOMIES Acceptable learning curve? Adequate oncological radicality?
10 Characteristic CASE CONTROL STUDY: Robotic lobectomy N=54 Open Lobectomy N=54 Men Women < (19) 95 (49-141) 95 (20) 90 (66-169) P value Sex Age (years) Objective: To evaluate learning curve and surgical radicality of robotic lobectomies in early stage NSCLC patients Method: 54 cases were performed by a single surgeon, using the da 4 arms Vinci system We used the propensity score matching, a statistical method that mimics randomization Control group (n=54) patients with the same characteristics submitted to open lobectomy FEV1% predicted Mean (standard deviation) Median (range) Lobe Lower Middle Upper Clinical tumor stage ct1 ct2 Clinical lymph node status cn0 cn1 cn2* cn3* ASA score BMI Less than or more Cardiac comorbidity No Yes Smoking status Never smoke Ex-smoker Current smoker
11 Learning curve The median time of robotic lobectomy decreased by 43 minutes between the first and the last two series of interventions (p=0.01) Overall it last in median 1 hour more than open surgery.
12 ROBOTIC LOBETCOMY Mean duration: 220 min Plateau reached after the first 18 cases Veronesi Innovation 2011 VATS LOBECTOMY Mean duration: 206 minutes Plateau reached after 50 cases HS Lee AATS 2009
13 LEARNING CURVE - SAFETY - RADICALITY ROBOT (54) OPEN (54) p value p value I II III I vs II+III II+III vs Open Complications 33% 22% 6% 19% Operative time < Postop days 6 days 5 days 4 days 6 days Median N LN ) Learning curve include 18 pts, complications, postoperative days and operative time declines with experience 2) Postoperative stay was SHORTEN after robotic than open procedures 3) Complications and N lymph nodes removed were comparable in open and robotic lobectomies Veronesi 2010 JTCS
14 ROBOTIC LOBECTOMY FOR NON-SMALL CELL LUNG CANCER (NSCLC): LONGTERM ONCOLOGIC RESULTS B.J. Park, F. Melfi, P. Maisonneuve, L. Spaggiari, R Da Silva, G. Veronesi Journal of Thoracic and Cardiovascular Surgery 2011 Pathologic stage IA IB IIA IIB IIIA (54%) (22%) (13%) (5%) (6%)
15 Ann Thorac Surg 2012;93: Case-control evaluation: 53 Robotic and 35 VATS Similar surgical and postoperative outcomes Significantly shorter duration of narcotic use and earlier return to normal activities after robotic approach The ability to perform mediastinal lymph node dissection was similar in the VATS and robotic approaches, however robotics gave greater confidence in dissecting N1 lymph nodes adjacent to the pulmonary artery, allowing easier and safer passage of the stapler
16 ROBOTIC LOBECTOMIES: TECHNIQUES Number of arms: 3 versus 4 Insufflation C02 Timing of utility incision Site of utility incision and other ports
17 4 ARMS ROBOTIC LOBECTOMY: SURGICAL TECHNIQUE Lateral position Robot at the head posteriorly Four incisions including a small utility incision Camera arm: VII space mid axillary line No rib spreading Individual ligation of hilar elements
18 ROBOTIC SEGMENTECTOMY
19 J Thorac Cardiovasc Surg 2006;132: Nonrandomized study for patients with a peripheral ct1n0m0 NSCLC < 2 cm able to tolerate a lobectomy Sublobar resection group (n 305) compared with lobar resection group (n 262) Conclusion: Extended segmentectomy should be considered as an alternative for patients with ct1n0m0 NSCLC of 2 cm or smaller
20 Thoracoscopic segmentectomy is a safe and feasible procedure for experienced TS, comparing favorably with OS by reducing hospital length of stay
21 Robotic anatomic lung segmentectomy is feasible, safe and reproducible in different centres Robotic system, by improving ergonomic, surgeon view and precise movements, may make minimally invasive segmentectomy easier to adopt and perform
22 Robotic segmentectomy: technique
23 Clinical case GE, F, 65 yy, Non solid nodule 16 mm RUL, SUV 1.1 FEV1 103%, Dlco/va 73%
24 Patient position Wedge resection Measure of nodule size and distance from margin As the nodule was >1 cm and PET positive > lymph node sampling Frosen section of margins and nodule (tumor type) Robot docking
25 Lymph node sampling R10 R2/R4 7 Negative frozen section R Limited resection Hystology: Adenocarcinoma G1 lepidic pattern 12 mm, margin 15 mm postoperative stay: 3 days
26 PERSONAL EXPERIENCE Robotic lung resection N Tumor mean size Conversions Oncological reason Anatomical reason Bleeding Technical Other Complications Minor Major mm (4-80mm) 19 (10%) (25%) Mean duration surgery Duration POS 170 minutes (last 30 cases) 4-5 days Learning curve 20 cases 80% of screen detected tumors resected with robotic approach
27 VATS AND ROBOTIC LYMPH NODE DISSECTION
28 RADICAL LYMPH NODE DISSECTION : GOLD STANDARD FOR THE TREATMENT OF LUNG CANCER Despite the recent results of the randomized trial that showed the adequacy of lymph node sampling, many surgeons favor complete resection of the mediastinal nodes. The randomized trial in fact only studied patients who were lymph node negative on frozen section for stations 4R, 7, and 10R on the right and for stations 5, 7, and 10L on the left. Darling GE American College of Surgery Oncology Group Z0030 trial. J Thorac Cardiovasc Surg 2011
29 A recent study from the STS database demonstrated that nodal Upstaging after lobectomy was significantly lower after VATS than after thoracotomy The study by Licht confirmed that N1 Upstaging was higher during Vats compared to open but number of station dissected and adjusted survival was not different
30 but is it feasible and safe during Robotic Lobectomy?
31 LEARNING CURVE - SAFETY - RADICALITY ROBOT (54) OPEN (54) p value p value I II III I vs II+III II+III vs Open Complications 33% 22% 6% 19% Operative time < Postop days 6 days 5 days 4 days 6 days Median N LN ) Complications, postoperative days and operative time declines across the 3 robotic tertiles 2) Postoperative stay was SHORTEN after robotic than open procedures 3) N lymph nodes removed were comparable in open and robotic lobectomies
32 N1 AND N2 UPSTAGING DURING SURGERY Stage Robotic (Park) VATS STS OPEN STS Clinical Pathological Upstaging Upstaging Upstaging N N % 6.7% 9.3% N % 4.9% 5% N1 Upstaging after robotic lobectomy is similar or even higher compared to upstaging after open lobectomy
33 J Thorac Cardiovasc Surg Retrospective results : 107 completely portal (no utility incision) 4-arm robotic lobectomies, compared to 318 propensity-matched cases undergoing nerve- and rib-sparing thoracotomy. Robotic group : lower morbidity and mortality, improved mental quality of life and shorter HS than the thoracotomy group. It shows similar total number of lymph nodes removed or in the median number of N2 or N1 lymph node stations assessed Cerfolio et al included cases with large tumours, N1 disease, or previous chemoradiation for nodal involvement. They have extended indications for minimally invasive lung cancer resection, as the robotic approach allows R0 resection for tumours up to 9.4 cm, and outstanding mediastinal and lymph node resection.
34 COSTS 30% VATS lobectomy from The Society of Thoracic Surgeons voluntary database 6% VATS lobectomy from nonvoluntary databases Higher costs of Robotics versus Vats will be justified if robotics will allow an higher transition from thoracotomy to minimally invasive surgery for early stage lung cancer
35 We analysed a consecutive series of clinical N0 screening detected lung malignancy to identify predictive criteria of nodal involvement. Preoperative PET scan c-stage T1-2N0M0 lung cancer 10mm / SUV <2 10mm / SUV 2 >10mm / SUV < 2 >10mm / SUV 2 < 3 cm Ø Anatomical resection + lymphadenectomy SCREENING pn0 pn+ (91) (17.1%) no prior treatment CLINIC pn0 pn+ (159) (2.3%) (22.2%) In cases of tumors larger than 1 cm and PET positive 17 to 22% 22% had hilar or mediastinal lymph node unexpected metastases
36 IEO Randomised Trial limited resection vs standard lobectomy Preoperative criteria: Suspicious or proven NSCLC; Lung nodules 2 cm; N0 at preoperative PET/CT; N0 prior treatment for lung cancer Intraoperative criteria: Diagnosis of NSCLC; Lesion suitable for a limited resection; No lymph node at FS when size > 1 cm and SUV positive; Negative margins Stratification Nodule Size ( 1 versus > 1 cm) PET on nodule (positive versus negative) Wedge or segmentectomy R Lobectomy with SND
37 SUMMARY 1 Randomized controlled trials are not available Robot-assisted approaches to lung cancer resection and lymph node dissection appear to offer comparable radicality and safety to VATS/open surgery. Learning curve is around 18 cases More intuitive movements, greater flexibility and high-definition threedimensional vision, render surgery easier for the surgeon, with shorter learning curve than VATS Radicality obtained at mediastinal level will probably extend indication of minimally invasive procedures to N1-N2 disease and post chemotherapy lobectomies. N1 upstaging after robotics is similar to open surgery High capital and running costs, limited instrument availability and long operating times are important disadvantages
38 SUMMARY 2 LR CONCLUSIONS SUMMARY Limited resections seems indicated in stage 1a disease and RCT are ongoing Vats anatomical segmentectomy are rarely reported due to demanding technique Early data show that robotic segmentectomy is feasible, safe and reproducible in different centres Robotic offers an excellent 3D view of the operative field and high precision of robotic Instruments, thus major bleeding is rare The four arm technique offers the possibility of an easy control of major vessel bleeding with the free Cadiere, and represents a safe procedure for major minimally invasive lung resection
Treatment of Clinical Stage I Lung Cancer: Thoracoscopic Lobectomy is the Standard
Treatment of Clinical Stage I Lung Cancer: Thoracoscopic Lobectomy is the Standard AATS General Thoracic Surgery Symposium May 5, 2010 Thomas A. D Amico MD Professor of Surgery, Duke University Medical
More informationClinical Commissioning Policy Proposition: Robotic assisted lung resection for primary lung cancer
Clinical Commissioning Policy Proposition: Robotic assisted lung resection for primary lung cancer Reference: NHS England B10X03/01 Information Reader Box (IRB) to be inserted on inside front cover for
More informationRobotic lobectomy: revolution or evolution?
Editorial Robotic lobectomy: revolution or evolution? Jules Lin Section of Thoracic Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA Correspondence to: Jules
More informationComplex Thoracoscopic Resections for Locally Advanced Lung Cancer
Complex Thoracoscopic Resections for Locally Advanced Lung Cancer Duke Thoracoscopic Lobectomy Workshop March 21, 2018 Thomas A. D Amico MD Gary Hock Professor of Surgery Section Chief, Thoracic Surgery,
More informationSurgery for early stage NSCLC
1-3 March 2017, Manchester, UK Surgery for early stage NSCLC Dominique H. Grunenwald, MD, PhD Professor Emeritus in Thoracic and Cardiovascular surgery Pierre & Marie Curie University. Paris. France what
More informationT3 NSCLC: Chest Wall, Diaphragm, Mediastinum
for T3 NSCLC: Chest Wall, Diaphragm, Mediastinum AATS Postgraduate Course April 29, 2012 Thomas A. D Amico MD Professor of Surgery, Chief of Thoracic Surgery Duke University Health System Disclosure No
More informationFacing Surgery for Lung Cancer? Learn about minimally invasive da Vinci Surgery
Facing Surgery for Lung Cancer? Learn about minimally invasive da Vinci Surgery Treatments & Surgery Options: The treatment and surgical options for the most common lung cancer, non-small cell lung cancer,
More informationLung cancer Surgery. 17 TH ESO-ESMO MASTERCLASS IN CLINICAL ONCOLOGY March, 2017 Berlin, Germany
17 TH ESO-ESMO MASTERCLASS IN CLINICAL ONCOLOGY 24-29 March, 2017 Berlin, Germany Lung cancer Surgery Sven Hillinger MD, Thoracic Surgery, University Hospital Zurich Case 1 59 y, female, 40 py, incidental
More informationRobotic assisted lobectomy and lymphadenectomy different approaches
Review Article Page 1 of 7 Robotic assisted lobectomy and lymphadenectomy different approaches Monica Casiraghi 1, Domenico Galetta 1, Lorenzo Spaggiari 1,2 1 Division of Thoracic Surgery, European Institute
More informationUniportal video-assisted thoracoscopic surgery segmentectomy
Case Report on Thoracic Surgery Page 1 of 5 Uniportal video-assisted thoracoscopic surgery segmentectomy John K. C. Tam 1,2 1 Division of Thoracic Surgery, National University Heart Centre, Singapore;
More informationOBJECTIVES. Solitary Solid Spiculated Nodule. What would you do next? Case Based Discussion: State of the Art Management of Lung Nodules.
Organ Imaging : September 25 2015 OBJECTIVES Case Based Discussion: State of the Art Management of Lung Nodules Dr. Elsie T. Nguyen Dr. Kazuhiro Yasufuku 1. To review guidelines for follow up and management
More informationThree-arm robot-assisted thoracoscopic surgery for locally advanced N2 non-small cell lung cancer
Surgical Technique Three-arm robot-assisted thoracoscopic surgery for locally advanced N2 non-small cell lung cancer Xinghua Cheng, Chongwu Li, Jia Huang, Peiji Lu, Qingquan Luo Shanghai Chest Hospital,
More informationVATS after induction therapy: Effective and Beneficial Tips on Strategy
VATS after induction therapy: Effective and Beneficial Tips on Strategy AATS Focus on Thoracic Surgery Mastering Surgical Innovation Las Vegas Nevada Oct. 27-28 2017 Scott J. Swanson, M.D. Professor of
More informationCharles Mulligan, MD, FACS, FCCP 26 March 2015
Charles Mulligan, MD, FACS, FCCP 26 March 2015 Review lung cancer statistics Review the risk factors Discuss presentation and staging Discuss treatment options and outcomes Discuss the status of screening
More informationsurgical approach for resectable NSCLC
surgical approach for resectable NSCLC Dominique H. Grunenwald, MD, PhD Professor Emeritus in Thoracic and Cardiovascular surgery Pierre & Marie Curie University. Paris. France 1933 Graham EA, Singer JJ.
More informationFour arms robotic-assisted pulmonary resection left lower lobectomy: how to do it
Surgical Technique Four arms robotic-assisted pulmonary resection left lower lobectomy: how to do it Alessandro Pardolesi 1, Luca Bertolaccini 2, Jury Brandolini 1, Piergiorgio Solli 1,2 1 Department of
More informationAccomplishes fundamental surgical tenets of R0 resection with systematic nodal staging for NSCLC Equivalent survival for Stage 1A disease
Segmentectomy Made Simple Matthew J. Schuchert and Rodney J. Landreneau Department of Cardiothoracic Surgery University of Pittsburgh Medical Center Financial Disclosures none Why Consider Anatomic Segmentectomy?
More informationstate of the art standard of care for resectable NSCLC surgical approach for resectable NSCLC
state of the art standard of care for resectable NSCLC surgical approach for resectable NSCLC Dominique H. Grunenwald, MD, PhD Professor Emeritus in Thoracic and Cardiovascular surgery Pierre & Marie Curie
More informationLung Cancer Clinical Guidelines: Surgery
Lung Cancer Clinical Guidelines: Surgery 1 Scope of guidelines All Trusts within Manchester Cancer are expected to follow this guideline. This guideline is relevant to: Adults (18 years and older) with
More informationVideo-assisted thoracoscopic surgery in lung cancer staging
Review Article on Thoracic Surgery Page 1 of 7 Video-assisted thoracoscopic surgery in lung cancer staging Frederico Krieger Martins, Guilherme Augusto Oliveira, Juliano Cé Coelho, Márcio Chmelnitsky Kruter,
More informationAdam J. Hansen, MD UHC Thoracic Surgery
Adam J. Hansen, MD UHC Thoracic Surgery Sometimes seen on Chest X-ray (CXR) Common incidental findings on computed tomography (CT) chest and abdomen done for other reasons Most lung cancers discovered
More informationRobotic lobectomies: when and why?
Review Article on Thoracic Surgery Robotic lobectomies: when and why? Sara Ricciardi 1, Giuseppe Cardillo 2, Carmelina Cristina Zirafa 1, Federico Davini 1, Franca Melfi 3 1 Division of Thoracic Surgery,
More informationParenchyma-sparing lung resections are a potential therapeutic
Lung Segmentectomy for Patients with Peripheral T1 Lesions Bryan A. Whitson, MD, Rafael S. Andrade, MD, and Michael A. Maddaus, MD Parenchyma-sparing lung resections are a potential therapeutic option
More informationSagar Damle, MD University of Colorado Denver May 23, 2011
Sagar Damle, MD University of Colorado Denver May 23, 2011 We have debated many times. Here are the topics, and a recap of the last few Pre-operative nutrition Babu pro; Damle con Utility of ECMO Babu
More informationSURGICAL TECHNIQUE. Radical treatment for left upper-lobe cancer via complete VATS. Jun Liu, Fei Cui, Shu-Ben Li. Introduction
SURGICAL TECHNIQUE Radical treatment for left upper-lobe cancer via complete VATS Jun Liu, Fei Cui, Shu-Ben Li The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China ABSTRACT KEYWORDS
More informationShiyou Wei 1,3, Minghao Chen 2, Nan Chen 1,3 and Lunxu Liu 1,3*
Wei et al. World Journal of Surgical Oncology (2017) 15:98 DOI 10.1186/s12957-017-1168-6 REVIEW Open Access Feasibility and safety of robot-assisted thoracic surgery for lung lobectomy in patients with
More informationIndications for sublobar resection for localized NSCLC
Indications for sublobar resection for localized NSCLC David H Harpole Jr, MD Professor of Surgery Associate Professor in Pathology Vice Chief, Division of Surgical Services Duke University School of Medicine
More informationThoracoscopic Lobectomy: Technical Aspects in Years of Progress
Thoracoscopic Lobectomy: Technical Aspects in 2015 16 Years of Progress 8 th Masters of Minimally Invasive Thoracic Surgery Orlando September 25, 2015 Thomas A. D Amico MD Gary Hock Professor of Surgery
More informationRobotic assisted VATS lobectomy for loco-regionally advanced non-small cell lung cancer
Surgical Technique Page 1 of 5 Robotic assisted VATS lobectomy for loco-regionally advanced non-small cell lung cancer Simon R. Turner, M. Jawad Latif, Bernard J. Park Thoracic Surgery Service, Memorial
More informationAshleigh Clark 1, Jessica Ozdirik 2, Christopher Cao 1,2. Introduction
Review Article Page 1 of 5 Thoracotomy, video-assisted thoracoscopic surgery and robotic video-assisted thoracoscopic surgery: does literature provide an argument for any approach? Ashleigh Clark 1, Jessica
More informationThoracoscopic Lobectomy for Locally Advanced Lung Cancer. Masters of Minimally Invasive Thoracic Surgery Orlando September 19, 2014
for Locally Advanced Lung Cancer Masters of Minimally Invasive Thoracic Surgery Orlando September 19, 2014 Thomas A. D Amico MD Gary Hock Endowed Professor and Vice Chair of Surgery Chief Thoracic Surgery
More informationFeasibility of four-arm robotic lobectomy as solo surgery in patients with clinical stage I lung cancer
Original Article Feasibility of four-arm robotic lobectomy as solo surgery in patients with clinical stage I lung cancer Seong Yong Park, Jee Won Suh, Kyoung Sik Narm, Chang Young Lee, Jin Gu Lee, Hyo
More informationHISTORY SURGERY FOR TUMORS WITH INVASION OF THE APEX 15/11/2018
30 EACTS Annual Meeting Barcelona, Spain 1-5 October 2016 SURGERY FOR TUMORS WITH INVASION OF THE APEX lung cancer of the apex of the chest involving any structure of the apical chest wall irrespective
More informationLungebevarende resektioner ved lungecancer metode og resultater
Dept. of Cardiothoracic Surgery Lungebevarende resektioner ved lungecancer metode og resultater Henrik Jessen Hansen Dept. of Cardiothoracic Surgery RT 2152, The National University Hospital. Copenhagen,
More informationTechniques and difficulties dealing with hilar and interlobar benign lymphadenopathy in uniportal VATS
Original Article on Thoracic Surgery Techniques and difficulties dealing with hilar and interlobar benign lymphadenopathy in uniportal VATS William Guido Guerrero 1, Diego Gonzalez-Rivas 1,2, Luis Angel
More informationLung Cancer. Current Therapy JEREMIAH MARTIN MBBCh FRCSI MSCRD
Lung Cancer Current Therapy JEREMIAH MARTIN MBBCh FRCSI MSCRD Objectives Describe risk factors, early detection & work-up of lung cancer. Define the role of modern treatment options, minimally invasive
More informationControversies in management of squamous esophageal cancer
2015.06.12 12.47.48 Page 4(1) IS-1 Controversies in management of squamous esophageal cancer C S Pramesh Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, India In Asia, squamous
More informationDIAGNÓSTICO Y TERAPIAS LOCALES. Rosario García Campelo Servicio de Oncología Médica Complejo Hospitalario Universitario A Coruña
DIAGNÓSTICO Y TERAPIAS LOCALES Rosario García Campelo Servicio de Oncología Médica Complejo Hospitalario Universitario A Coruña SIDNEY 2013 THE CHALLENGE THE THREE SISTERS: IMAGING, PATHOLOGY AND LOCAL
More informationFour-arm robotic lobectomy for the treatment of early-stage lung cancer
GENERAL THORACIC SURGERY Four-arm robotic lobectomy for the treatment of early-stage lung cancer Giulia Veronesi, MD, a Domenico Galetta, MD, a Patrick Maisonneuve, DipEng, b Franca Melfi, MD, c Ralph
More informationPost-Induction PET Does Not Correlate with Persistent Nodal Disease or Overall Survival in Surgically Treated Stage IIIA Non-Small Cell Lung Cancer
Post-Induction PET Does Not Correlate with Persistent Nodal Disease or Overall Survival in Surgically Treated Stage IIIA Non-Small Cell Lung Cancer R. Taylor Ripley, Kei Suzuki, Kay See Tan, Manjit Bains,
More informationVATS Segmentectomy. Duke Masters Course Sept 2015
VATS Segmentectomy Duke Masters Course Sept 2015 Scott J. Swanson, M.D. Director, Minimally Invasive Thoracic Surgery Brigham and Women s Hospital Chief Surgical Officer Dana Farber Cancer Institute Professor
More informationACOSOG Thoracic Committee. Kemp H. Kernstine, MD PhD
ACOSOG Thoracic Committee Kemp H. Kernstine, MD PhD ACOSOG Thoracic Committee Chair: Bryan Meyers, M.D., MPH Vice Chairs: Malcolm Brock, MD Tom DiPetrillo, M.D. Ramaswamy Govindan, M.D. Carolyn Reed, MD
More informationACOSOG (NCCTG, CALGB) Alliance Thoracic Committee Kemp H. Kernstine, MD PhD
ACOSOG (NCCTG, CALGB) Alliance Thoracic Committee Kemp H. Kernstine, MD PhD 7-12-12 ACOSOG Thoracic Committee Chair: Bryan Meyers, M.D., MPH Vice Chairs: Malcolm Brock, MD Tom DiPetrillo, M.D. Ramaswamy
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Adenocarcinoma, pancreatic ductal, laparoscopic distal pancreatectomy for, 61 Adrenal cortical carcinoma, laparoscopic adrenalectomy for, 114
More informationLA TIMECTOMIA ROBOTICA
LA TIMECTOMIA ROBOTICA Prof. Giuseppe Marulli UOC Chirurgia Toracica Università di Padova . The thymus presents a challenge to the surgeon not only as a structure that may be origin of benign and malignant
More informationCurrent innovations in colorectal surgery
Current innovations in colorectal surgery KS Chapple Consultant Colorectal Surgeon Sheffield Teaching Hospitals NHS Trust Do we need more innovations? What innovations are there and are they worthwhile?
More informationInnovations in Lung Cancer Diagnosis and Surgical Treatment
Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including
More informationSuperior and Basal Segment Lung Cancers in the Lower Lobe Have Different Lymph Node Metastatic Pathways and Prognosis
ORIGINAL ARTICLES: Superior and Basal Segment Lung Cancers in the Lower Lobe Have Different Lymph Node Metastatic Pathways and Prognosis Shun-ichi Watanabe, MD, Kenji Suzuki, MD, and Hisao Asamura, MD
More informationUniportal video-assisted thoracic surgery for complicated pulmonary resections
Review Article on Thoracic Surgery Uniportal video-assisted thoracic surgery for complicated pulmonary resections Ding-Pei Han, Jie Xiang, Run-Sen Jin, Yan-Xia Hu, He-Cheng Li Jiaotong University School
More informationTreatment of oligometastatic NSCLC
Treatment of oligometastatic NSCLC Jarosław Kużdżał Department of Thoracic Surgery Jagiellonian University Collegium Medicum, John Paul II Hospital, Cracow New idea? 14 NSCLC patients with solitary extrathoracic
More informationRobotic lobectomy for non small cell lung cancer (NSCLC): Long-term oncologic results
GENERAL THORACIC SURGERY Robotic lobectomy for non small cell lung cancer (NSCLC): Long-term oncologic results Bernard J. Park, MD, a Franca Melfi, MD, b Alfredo Mussi, MD, b Patrick Maisonneuve, DipEng,
More informationUnderstanding surgery
What does surgery for lung cancer involve? Surgery for lung cancer involves an operation, which aims to remove all the cancer from the lung. Who will carry out my operation? In the UK, we have cardio-thoracic
More informationFOR PUBLIC CONSULTATION ONLY. Evidence Review: Robotic assisted lung resection for primary lung cancer
Evidence Review: Robotic assisted lung resection for primary lung cancer NHS England Evidence Review: Robotic assisted lung resection for primary lung cancer First published: November 2015 Updated: Prepared
More informationVideo-assisted thoracoscopic (VATS) lobectomy has
Robot-Assisted Lobectomy for Early-Stage Lung Cancer: Report of 100 Consecutive Cases Farid Gharagozloo, MD, Marc Margolis, MD, Barbara Tempesta, MS, CRNP, Eric Strother, LSA, and Farzad Najam, MD Washington
More informationHistory of Surgery for Lung Cancer
Welcome to Master Class for Oncologists Session 1: 7:30 AM - 8:15 AM San Francisco, CA October 23, 2009 Innovations in The Surgical Treatment of Lung Cancer Speaker: Scott J. Swanson, MD 2 Presenter Disclosure
More informationNavigational bronchoscopy-guided dye marking to assist resection of a small lung nodule
Case Report on Aerodigestive Endoscopy Navigational bronchoscopy-guided dye marking to assist resection of a small lung nodule Jennifer L. Sullivan 1, Michael G. Martin 2, Benny Weksler 1 1 Division of
More informationJia Huang #, Jiantao Li #, Hanyue Li, Hao Lin, Peiji Lu, Qingquan Luo. Original Article
Original Article Continuous 389 cases of Da Vinci robot-assisted thoracoscopic lobectomy in treatment of non-small cell lung cancer: experience in Shanghai Chest Hospital Jia Huang #, Jiantao Li #, Hanyue
More informationMastering Thoracoscopic Upper Lobectomy
Mastering Thoracoscopic Upper Lobectomy Duke Thoracoscopic Lobectomy Workshop March 21, 2018 Thomas A. D Amico MD Gary Hock Professor of Surgery Section Chief, Thoracic Surgery, Duke University Medical
More informationCheng-Yang Song, Takehiro Sakai, Daisuke Kimura, Takao Tsushima, Ikuo Fukuda
Original Article Comparison of perioperative and oncological outcomes between video-assisted segmentectomy and lobectomy for patients with clinical stage IA non-small cell lung cancer: a propensity score
More information11/21/ M with LUL Mass Case Presentation / Round Table Discussion. Multiple-choice question What stage is this tumor?
MS 62M with LUL Mass Case Presentation / Round Table Discussion Dr. Jasleen Kukreja and Johannes Kratz Department of Thoracic Surgery University of California, San Francisco 62M, presented to clinic 6/2009
More informationRobotic-assisted pulmonary resection - Right upper lobectomy
Art of Operative Techniques Robotic-assisted pulmonary resection - Right upper lobectomy Robert J. Cerfolio, Ayesha S. Bryant JH Estes Family Endowed Chair for Lung Cancer Research, Division of Cardiothoracic
More informationLong-term respiratory function recovery in patients with stage I lung cancer receiving video-assisted thoracic surgery versus thoracotomy
Original Article Long-term respiratory function recovery in patients with stage I lung cancer receiving video-assisted thoracic surgery versus thoracotomy Tae Yun Park 1,2, Young Sik Park 2 1 Division
More informationLung Cancer Role of Surgery. Ricardo M. Terra Associate Professor of Thoracic Surgery University of Sao Paulo Medical School
Lung Cancer Role of Surgery Ricardo M. Terra Associate Professor of Thoracic Surgery University of Sao Paulo Medical School Disclosure Scientific Consultant/Advisory Board: Johnson&Johnson Educational
More informationVATS Metastasectomy. Inderpal (Netu) S. Sarkaria, MD, FACS
VATS Metastasectomy Inderpal (Netu) S. Sarkaria, MD, FACS Vice Chairman, Clinical Affairs Director, Robotic Thoracic Surgery Co-Director, Esophageal and Lung Surgery Institute Disclosures Speaking & Education:
More informationRuijin robotic thoracic surgery: S segmentectomy of the left upper lobe
Case Report Page 1 of 5 Ruijin robotic thoracic surgery: S 1+2+3 segmentectomy of the left upper lobe Han Wu, Su Yang, Wei Guo, Runsen Jin, Yajie Zhang, Xingshi Chen, Hailei Du, Dingpei Han, Kai Chen,
More informationMEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER
MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER Tsuneyo Takizawa, MD a Masanori Terashima, MD a Teruaki Koike, MD a Hideki Akamatsu, MD a Yuzo
More informationRobot assisted thoracic surgery: a review of current literature.
Review http://www.alliedacademies.org/annals-of-cardiovascular-and-thoracic-surgery/ Robot assisted thoracic surgery: a review of current literature. Charles D Ghee, Wickii T Vigneswaran * Department of
More information8th Edition of the TNM Classification for Lung Cancer. Proposed by the IASLC
8th Edition of the TNM Classification for Lung Cancer Proposed by the IASLC Introduction Stage classification - provides consistency in nomenclature - improves understanding of anatomic extent of tumour
More informationMultifocal Lung Cancer
Multifocal Lung Cancer P. De Leyn, MD, PhD Department of Thoracic Surgery University Hospitals Leuven Belgium LEUVEN LUNG CANCER GROUP Department of Thoracic Surgery Department of Pneumology Department
More informationSlide 1. Slide 2. Slide 3. Investigation and management of lung cancer Robert Rintoul. Epidemiology. Risk factors/aetiology
Slide 1 Investigation and management of lung cancer Robert Rintoul Department of Thoracic Oncology Papworth Hospital Slide 2 Epidemiology Second most common cancer in the UK (after breast). 38 000 new
More informationRobotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer
Original Article Robotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer Mong-Wei Lin, Shuenn-Wen Kuo, Shun-Mao Yang, Jang-Ming Lee Department of Surgery, National Taiwan University
More informationDetermining the Optimal Surgical Approach to Esophageal Cancer
Determining the Optimal Surgical Approach to Esophageal Cancer Amit Bhargava, MD Attending Thoracic Surgeon Department of Cardiovascular and Thoracic Surgery Open Esophagectomy versus Minimally Invasive
More informationVideo-Mediastinoscopy Thoracoscopy (VATS)
Surgical techniques Video-Mediastinoscopy Thoracoscopy (VATS) Gunda Leschber Department of Thoracic Surgery ELK Berlin Chest Hospital, Berlin, Germany Teaching Hospital of Charité Universitätsmedizin Berlin
More informationLarry Tan, MD Thoracic Surgery, HSC. Community Cancer Care Educational Conference October 27, 2017
Larry Tan, MD Thoracic Surgery, HSC Community Cancer Care Educational Conference October 27, 2017 To describe patient referral & triage for the patient with suspected lung cancer To describe the initial
More informationTristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease
Tristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease Jennifer E. Tseng, MD UFHealth Cancer Center-Orlando Health Sep 12, 2014 Background Approximately
More informationThoracoscopic Lobectomy Is Associated With Superior Compliance With Adjuvant Chemotherapy in Lung Cancer
Thoracoscopic Lobectomy Is Associated With Superior Compliance With Adjuvant Chemotherapy in Lung Cancer Jin Gu Lee, MD, Byoung Chul Cho, MD, Mi Kyung Bae, MD, Chang Young Lee, MD, In Kyu Park, MD, Dae
More informationFive on a dice port placement for robot-assisted thoracoscopic right upper lobectomy using robotic stapler
Surgical Technique Five on a dice port placement for robot-assisted thoracoscopic right upper lobectomy using robotic stapler Min P. Kim, Edward Y. han ivision of Thoracic Surgery, epartment of Surgery,
More informationThoracoscopic S 6 segmentectomy: tricks to know
Surgical Technique Page 1 of 6 Thoracoscopic S 6 segmentectomy: tricks to know Agathe Seguin-Givelet 1,2, Jon Lutz 1, Dominique Gossot 1 1 Thoracic Department, Institut Mutualiste Montsouris, Paris, France;
More informationMINIMALLY INVASIVE ESOPHAGECTOMY FOR CANCER: where do we stand?
MINIMALLY INVASIVE ESOPHAGECTOMY FOR CANCER: where do we stand? Ph Nafteux, MD Copenhagen, Nov 3rd 2011 Department of Thoracic Surgery, University Hospitals Leuven, Belgium W. Coosemans, H. Decaluwé, Ph.
More informationRole of Surgery in Management of Non Small Cell Lung Cancer. Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City
Role of Surgery in Management of Non Small Cell Lung Cancer Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City Introduction Surgical approach Principle and type of surgery
More informationEarly Rectal Cancer Surgical options Organ Preservation? Chinna Reddy Colorectal Surgeon Western General, Edinburgh
Early Rectal Cancer Surgical options Organ Preservation? Chinna Reddy Colorectal Surgeon Western General, Edinburgh What is Early rectal cancer? pt1t2n0m0 Predictors for LN involvement Size Depth Intramural
More informationVideo-Assisted Thoracic Surgery (VATS) Lobectomy: the Evidence Base
SCIENTIFIC PAPER Video-Assisted Thoracic Surgery (VATS) Lobectomy: the Evidence Base Naveed Alam, MD, Raja M. Flores, MD ABSTRACT Background: Video-assisted thoracic surgery (VATS) lobectomy provides a
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationReasons for conversion during VATS lobectomy: what happens with increased experience
Review Article on Thoracic Surgery Page 1 of 5 Reasons for conversion during VATS lobectomy: what happens with increased experience Dario Amore, Davide Di Natale, Roberto Scaramuzzi, Carlo Curcio Division
More informationTotally thoracoscopic left upper lobe tri-segmentectomy
Masters of Cardiothoracic Surgery Totally thoracoscopic left upper lobe tri-segmentectomy Dominique Gossot Thoracic Department, Institut Mutualiste Montsouris, Paris, France Correspondence to: Dominique
More informationMEDIASTINAL STAGING surgical pro
MEDIASTINAL STAGING surgical pro Paul E. Van Schil, MD, PhD Department of Thoracic and Vascular Surgery University of Antwerp, Belgium Mediastinal staging Invasive techniques lymph node mapping cervical
More informationThoracic Surgery; An Overview
Thoracic Surgery What we see Thoracic Surgery; An Overview James P. Locher, Jr, MD Methodist Cardiovascular and Thoracic Surgery Lung cancer Mets Fungus and TB Lung abcess and empyema Pleural based disease
More informationThe Itracacies of Staging Patients with Suspected Lung Cancer
The Itracacies of Staging Patients with Suspected Lung Cancer Gerard A. Silvestri, MD,MS, FCCP Professor of Medicine Medical University of South Carolina Charleston, SC silvestri@musc.edu Staging Lung
More informationUniportal video-assisted thoracoscopic surgery following neoadjuvant chemotherapy for locally-advanced lung cancer
Yang and Zhai Journal of Cardiothoracic Surgery (2018) 13:33 https://doi.org/10.1186/s13019-018-0714-9 RESEARCH ARTICLE Open Access Uniportal video-assisted thoracoscopic surgery following neoadjuvant
More informationPredictive risk factors for lymph node metastasis in patients with resected nonsmall cell lung cancer: a case control study
Moulla et al. Journal of Cardiothoracic Surgery (2019) 14:11 https://doi.org/10.1186/s13019-019-0831-0 RESEARCH ARTICLE Open Access Predictive risk factors for lymph node metastasis in patients with resected
More informationPerioperative outcomes and lymph node assessment after induction therapy in patients with clinical N1 or N2 non-small cell lung cancer
Original Article Perioperative outcomes and lymph node assessment after induction therapy in patients with clinical N1 or N2 non-small cell lung cancer Jessica Glover 1, Frank O. Velez-Cubian 2, Kavian
More informationda Vinci Prostatectomy My Greek personal experience
da Vinci Prostatectomy My Greek personal experience Vassilis Poulakis MD, PhD, FEBU Ass. Prof. of Urology Director of Urologic Clinic Doctors Hospital Athens Laparoscopy - golden standard in Urology -
More informationEarly and locally advanced non-small-cell lung cancer (NSCLC)
Early and locally advanced non-small-cell lung cancer (NSCLC) ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up P. E. Postmus, K. M. Kerr, M. Oudkerk, S. Senan, D. A. Waller, J.
More informationThoracoscopic wedge resection and segmentectomy for smallsized pulmonary nodules
Perspective on Thoracic Surgery Thoracoscopic wedge resection and segmentectomy for smallsized pulmonary nodules Hirohisa Kato, Hiroyuki Oizumi, Jun Suzuki, Akira Hamada, Hikaru Watarai, Kenta Nakahashi,
More informationThe accurate assessment of lymph node involvement is
ORIGINAL ARTICLE Which is the Better Prognostic Factor for Resected Non-small Cell Lung Cancer The Number of Metastatic Lymph Nodes or the Currently Used Nodal Stage Classification? Shenhai Wei, MD, PhD,*
More informationVATS Lobectomy Tecnica triportale
VATS Lobectomy Tecnica triportale Prof. Giuseppe Marulli UOC Chirurgia Toracica Policlinico Universitario di Padova VATS LOBECTOMY: FIRST EXPERIENCES CLINICAL MAIN CONCERNS Morbidity/mortality rates comparable
More information4D Radiotherapy in early ca Lung. Prof. Manoj Gupta Dept of Radiotherapy & oncology I.G.Medical College Shimla
4D Radiotherapy in early ca Lung Prof. Manoj Gupta Dept of Radiotherapy & oncology I.G.Medical College Shimla Presentation focus on ---- Limitation of Conventional RT Why Interest in early lung cancer
More informationThe 7th Edition of TNM in Lung Cancer.
10th European Conference Perspectives in Lung Cancer. Brussels, March 2009. The 7th Edition of TNM in Lung Cancer. Peter Goldstraw, Consultant Thoracic Surgeon, Royal Brompton Hospital, Professor of Thoracic
More informationSurgical Approaches to Pulmonary Metastases
Surgical Approaches to Pulmonary Metastases Raja M Flores MD Professor and Chief Thoracic Surgery Mount Sinai School of Medicine New York, New York History of Lung Metastasectomy 1882 Weinlechner +CW 1926
More informationRobotic-assisted pulmonary segmentectomies
Review Article on Thoracic Surgery Page 1 of 10 Robotic-assisted pulmonary segmentectomies Pierluigi Novellis 1, Edoardo Bottoni 1, Marco Alloisio 1,2, Frank O. Velez-Cubian 3, Eric M. Toloza 3,4,5, Giulia
More information