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Supplement: The Minimally Invasive Thoracic Surgery Summit

Video-Assisted Thoracoscopic Surgery versus Robotic-Assisted Thoracoscopic Surgery Thymectomy

Clinical Department of General and Transplant Surgery, Innsbruck Medical University, Innsbruck, Austria

^_* Address correspondence to Dr Bodner, Department of General and Transplant Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria (Email: Johannes.bodner@i-med.ac.at).

Presented at the Minimally Invasive Thoracic Surgery Summit, New York, NY, June 8–9, 2007.

The first 300 words of the full text of this article appear below.

	Introduction

 
The correct treatment of diseases of the thymic gland has remained a matter of debate in thoracic surgery. Indications for thymectomy primarily include suspected thymoma, myasthenia gravis with and without thymoma, and thymic cysts [1–4].

Regardless of the underlying disease indicating thymectomy, complete removal of the entire thymus is always mandatory because of potentially ectopic thymic tissue. This is not uniformly achieved by all the approaches used worldwide. Thus, the optimal surgical approach—combining a high degree of resection of the thymic gland and its perithymic fat tissue with low surgical invasiveness—is still controversial [5–8].

The introduction of complete robotic surgical systems in the late 1990s contributed to the field of minimally invasive surgery. It soon became obvious that these devices are most advantageous in tiny and difficult to reach anatomic regions. The mediastinum has thus become a hot spot for thoracic surgeons using robotic assistance, and procedures like thymectomy, thymusectomy, resection of paravertebral tumors or ectopic (para-) thyroidectomy have been shown to be feasible and safe when performed with robotic assistance [9–11].

Innsbruck Medical University Hospital purchased a 3-arm da Vinci operating robot (Intuitive Surgical Inc, Mountain View, CA) in June 2001; to date, 32 robotic thymectomy procedures have been performed. Written informed consent was obtained from all patients. Use of the da Vinci system was approved by the local ethics committee. A review of the patient charts back to 1999 shows that only four thoracoscopic thymectomies were performed with a conventional video-assisted thoracoscopic surgical approach (VATS); therefore, direct comparison of our results for the two types of thymectomy is not appropriate.

A benefit of the robotic-assisted thoracoscopic surgical (RATS) approach to thymectomy compared with the conventional VATS approach has not yet been proven. When combining our institutional experience with the robotic approach and . . . [Full Text of this Article]