Author of

• 15343

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  P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Locoregional Disease – NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15348

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    P3.03-005 - Review of the Impact of Robotic Surgery on Pulmonary Resections Performed at a Comprehensive Cancer Center (ID 2697)

    09:30 - 09:30  |  Author(s): T. Williams
    • Abstract

    Background:
    Minimally invasive surgical techniques have emerged as potential platforms for improving surgical outcomes. Thoracoscopic pulmonary resection was developed in the mid 1990’s but has yet to achieved dominance as the resection approach of choice. Robotic-assisted pulmonary resection has been developed in a number of institutions. In this report we will review the impact of the robotic platform on pulmonary resections at a comprehensive cancer center.
    
    Methods:
    All robotic cases were entered prospectively into an IRB outcomes database. Comparable data for open and thoracoscopic procedures was retrieved from our STS database submissions. We limited the review to the procedures performed by a single surgeon to eliminate the impact of multiple learning curves on the robotic resections. We reviewed 330 robotic pulmonary resections culled from the total robotic experience of 503 between 2010 through March, 2015. Single-surgeon data for open cases was retrieved for the same time frame through the STS database. We evaluated percentage of minimally invasive cases annually, length of stay, length of procedure, complications, duration of air leak, readmissions and mortality.
    
    Results:
    Between 2010 and 2015 the percentage of minimally invasive lobectomies performed annually increased from 23 % to 94%. Conversions from robotic approach to open decreased from 8% in the first 100 cases to 4% in the last 100 cases. Mortality for robotic lobectomy was 0.8% compared to open lobectomy 2.0%. Readmission rate for robotic resections was 9.7 % compared to 16% for open cases. Only a single robotic case was readmitted for pain management. There was a trend to lower post-operative pneumonia incidence in the minimally invasive group.
    
    Conclusion:
    In our single institution, single surgeon experience, adding the robotic platform quadrupled the percentage of lobectomies accomplished with a minimally invasive approach. There was a continued decrease in length of procedure as team experience accumulated. The outcomes measures of mortality, readmission, length of stay and pneumonia demonstrated advantage to the robotic platform. Robotic pulmonary resection may be the platform for increasing minimally invasive resections. Throughput metrics of operating time, length of stay and readmission are favored in the robotically performed procedures with an experienced team.