Microlobectomy: A Novel Form of Endoscopic Lobectomy

• Published in: Innovations (Philadelphia, Pa.) Pa.), 2017-07, Vol.12 (4), p.247-253
• Main Authors: Dunning, Joel, Elsaegh, Mohamed, Nardini, Marco, Gillaspie, Erin A., Horsleben Petersen, Rene, Jessen Hansen, Henrik, Helsel, Bryan, Naase, Hatam, Kornaszewska, Malgorzata, Will, Malcolm B., Walker, William S., Wigle, Dennis, Haley Blackmon, Shanda
• Format: Article
• Language: English
• ISSN: 1556-9845; 1559-0879
• DOI: 10.1177/155698451701200403

Objective Microlobectomy is a novel form of videoscopic-assisted thoracic surgery lobectomy. Strict inclusion criteria consist of the following: no intercostal incisions greater than 5 mm, 12 mm subxiphoid port, subxiphoid removal of the specimen, total endoscopic technique with CO2 insufflation, vision through a 5-mm camera, stapling via the subxiphoid port, or with 5-mm stapling devices. Methods The combined early experiences of six hospitals from three countries were combined from September 2014 to May 2016. During that time, the study represents a consecutive cohort study of this technique. Results Seventy-two patients underwent microlobectomy. The median (range) age was 66 (27–82). Half of the patients were female. There were 48 right-sided resections and 24 on the left. There were four segmental resections and there was one right pneumonectomy. Four operations were performed robotically (with 8-mm intercostal incisions). The median (range) operative time was 180 (94–285) minutes and the blood loss was 118 (5–800) mL. There were three conversions to thoracotomy and two conversions to videoscopic-assisted thoracic surgery by means of an intercostal utility incision to complete the operation. The median (range)length of stay was 3(1–44) days and 30 patients (42%) when home by day 2 and 16 patients (22%) were discharged on day 1. There were no deaths. Five patients (7%) had a prolonged airleak. There were no wound infections and there was one incisional hernia. Conclusions We believe that microlobectomy is an interesting novel form of videoscopic-assisted thoracic surgery lobectomy and has several theoretical advantages. We have presented our early results and hope that this will stimulate others to investigate this type of videoscopic-assisted thoracic surgery lobectomy further.