title: Advanced thoracoscopic procedures are facilitated by computer-aided robotic technology.
abstract: OBJECTIVE
  Computer (robotic) enhancement has been used to facilitate simple thoracoscopic procedures such as internal mammary artery (IMA) mobilization. This report describes the use of robotic technology in advanced thoracoscopic procedures.
  
  
  METHODS
  Ten patients underwent advanced thoracoscopic procedures utilizing the Da Vinci robotic surgical system (Intuitive Surgical, Mountain View, CA) at our institution.
  
  
  RESULTS
  Patients 1-6 underwent endoscopic phrenic nerve mobilization with insertion of phrenic nerve pacemakers. The indications were quadriplegia (n=2), central hypoventilation syndrome (n=2), and intractable hiccups (n=2). Three 1-cm incisions were made to access each hemithorax. Patients 7 and 8 underwent robotically assisted resection of posterior mediastinal masses. Patient 9 underwent robotically assisted thoracoscopic left lower lobectomy for a lung mass. Patient 10 underwent robotically assisted left ventricular lead placement for biventricular pacing for heart failure.
  
  
  CONCLUSIONS
  Robotic technology can be used to perform advanced intrathoracic maneuvers thoracoscopically. The increased visualization and instrument dexterity afforded by this technology may facilitate the development of minimally invasive thoracic approaches that were previously not feasible.
authors.affiliation: Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA. jm2240@columbia.edu
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Morgan
authors.forename: Mark E
authors.initials: ME
authors.lastname: Ginsburg
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Sonett
authors.forename: David L S
authors.initials: DL
authors.lastname: Morales
authors.forename: Takushi
authors.initials: T
authors.lastname: Kohmoto
authors.forename: Lyall A
authors.initials: LA
authors.lastname: Gorenstein
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
authors.forename: Michael
authors.initials: M
authors.lastname: Argenziano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004558:Electric Stimulation; D005260:Female; D006333:Heart Failure / Q000601:surgery; D006801:Humans; D008168:Lung / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009369:Neoplasms / Q000601:surgery; D010138:Pacemaker, Artificial; D010791:Phrenic Nerve; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D035441:Thoracic Wall / Q000601:surgery; D013906:Thoracoscopy / Q000379:methods