Chinese Journal of Clinicians, Vol 6, No 7 (2012)

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Robotic thymus resection with da Vinci surgical system:a report of 31 cases

DONG Guo-hua, YI Jun, LI Hao, XU Biao, YAO Sheng, LIU Can-hui, LI De-min, SHEN Yi, JING Hua

Abstract


  Objective To summarize the basic experience of robotic thymus resection using da Vinci surgical system,and to evaluate its value in clinical application.Methods From Jun 2010 to Nov 2011,31 patients with thymus disease(including 23 cases of thymoma,4 cases of thymic hyperplasia,3 cases of thymic cysts and 1 case of tuberculous granuloma in anterior mediastinum),among whom 21 patients suffered from myasthenia gravis,underwent thymus resection and dissection of fat tissue outside the pericardium with da Vinci S surgical robot.Results All patients were successfully operated,and no conversion to thoracotomy occurred.27 patients used right side route and 4 used left side route.The operative time was 42-132 min,mean(62.6±23.7)min,the estimated blood loss was 20-150 ml,mean(53.9±29.3)ml,and the post-operative 24 h drainage was 50-220 ml,mean(122.6±46.5)ml.All patients were extubated at 2-36 h,mean(14.6±8.6)h after surgery.One patient with OssermanⅡB type myasthenia gravis got myasthenic crisis 4 d post operation,and recovered by reintubation and medical therapy.No other major complications were experienced;no peri-operative mortality occurred.The mean hospital stay was 5-19 d,mean(11.3±3.3)d.All the patients were followed up,and all the patient with myasthenia gravis achieved symptomatic relief.Conclusions With da Vinci robotic system,the thymic tissue and perithymic fatty tissue in the mediastinum can be dissected completely.The robotic thymection is feasible and safe,and the results are satisfactory.

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Chinese Journal of Clinicians