Master Video Presentation: Robotic assisted tracheal resection with reconstruction

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Master Video Presentation — IACTS Thoracic CME 2025 Kolkata
Robotic-Assisted tracheal resection with reconstruction without ECMO for lower tracheal malignancy

Presented by:
Dr. Devendra Parikh, Surgical Oncologist
Aastha Oncology Associates

This video demonstrates robotic tracheal resection with reconstruction for a distal tracheal mucoepidermoid carcinoma without ECMO, without jet ventilation. Da Vinci Xi system is used to perform this procedure.
Patient position is semi prone position. 4 robotic ports and 2 assistant ports were used for the procedure.
For ventilatory purpose, ivory fasciomaxillary tube 6Number was used considering its longer length. sterile armoured flexometalic tube was kept ready as a plan-B (if required to be inserted from 15 mm assistant port in 4th ICS in midaxillary line).
Steps :
Exposure of tracheobronchial tree by dividing mediastinal pleura (safeguarding right vagus nerve and its right bronchial branches).
subcarinal and right paratracheal LN dissection.
circumferential mobilization of trachea from thoracic inlet right up to left bronchus.
Resection of trachea with clear margin (bronchoscopy guided resection).
Reconstruction of trachea with barbed sutures.
Esophageal patch to reinforce the repair.
Leak test followed by closure of mediastinal pleura.
This is the unique case report of robotic tracheal resection without the use of ECMO or jet ventilation.
Robotic technology with its 4 arms enables surgeon and anaesthetist to perform the difficult procedure with out changing endotracheal tube with satisfactory outcomes.

Specimen Retrieval
Specimen was extracted from 15 mm assistant port kept in the anterior axillary line.

Instruments and Staplers Used:
Fenestrated bipolar forceps
Monopolar curved scissors
Maryland bipolar forceps
Needle driver
30° telescope
Robotic clip applicator

This video highlights the precision, safety, and ergonomic advantages of robotic surgery in performing complex thoracic procedure, emphasizing the value of minimally invasive techniques in advanced oncology care.
Categoria
Oncology
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