Robotic Thoracic Surgery
Thoracic surgery is an integral part of the Mount Sinai Robotics Institute (MSRI). Our surgeons employ robotic technology to treat the heart, lungs, esophagus, and other organs in the chest. Many patients who are candidates for open surgery can benefit from robotic procedures as well.
Our robotic thoracic surgeons perform procedures while the patients is under general anesthesia. We insert a pen-sized cannula (port) with a camera on the end so that we can see our movements inside the patient’s chest. Then we insert one or two additional cannulae with fully flexible instruments on the end. One surgeon sits at a console, manipulating the instruments using a joystick, while another surgeon sits at the patient’s bedside. If we remove a tumor, we place it in a bag before bringing it outside the body. Most procedures take one to three hours.
Pioneering Robotic Thoracic Surgery Program
We at the Mount Sinai Health System have been performing minimally invasive robotic surgery since 2003. Our surgeons are some of the most experienced in the world, having been pioneers in the field. Some of the key highlights of our program are:
2003 - First to use robotically assisted left ventricular epicardial lead implantation for biventricular pacing
2003 - Performed the first robotic thymectomy for myasthenia gravis in the United States
2003 - Performed the first robot-assisted lobectomy in the United States
2006 - First robotic implantation of brachytherapy seeds to treat lung cancer
2012 - First reverse of thoracic sympathectomy
Thoracic Conditions We Treat with Robotic Surgery
We treat a variety of thoracic conditions with robotic technology, including various cancers, low-grade tumors, and benign disorders.
- Lung cancer
- Esophageal cancer
- Mediastinal tumors (including thymoma, teratoma, and germ cell tumors)
- Schwannoma and neurogenic tumors
- Chest wall and pleural tumors, including fibrous tumors of the pleura
- Thymectomy for myesthenia gravis
- Lung nodule resections
- Hyperhydrosi s reversal
- Gastroesophageal reflux disease
- Interstitial lung diseases
Types of Robotic Thoracic Procedures Offered at Mount Sinai
To treat the above conditions, Mount Sinai’s thoracic surgery team performs a broad spectrum of procedures including:
- Robot-assisted lobectomy, segmentectomy, and other lung resections
- Navigation-guided precision lung resections
- Minimally invasive esophagectomy
- Nissen fundoplication
- Paraesophageal hernia repair
- Heller myotomy
- Robotic-assisted thymectomy
- Tracheal procedures
- Sympathectomy and reversal of sympathectomy
- Anti-reflux operations
- Repair of diaphragmatic hernia
- Resection of chest wall and pleural tumors
Patient Benefits of Robotic Thoracic Surgery
For qualified candidates, a robotic surgical approach may be an option, as it offers the advantages of minimally invasive surgery. By using minimally invasive robotic surgery, we do not need to open the patient’s chest wall and spread the ribs because we can perform the procedures with a few small instruments, versus having to place their hands into the chest. In addition, we can see what is happening in the chest more clearly with robotic technology because the camera provides three-dimensional images (open surgery offers two-dimensional views) that we can magnify to ten times the actual size. The small instruments also provide great dexterity and precision.
For patients, robotic surgery offers numerous advantages:
- Reduced pain and discomfort, which means less use of narcotics
- Decreased risk of wound infection
- Minimal scarring because the incisions are so small
- Decreased pain because we don’t have to spread your ribs
- Quicker recuperation and return to normal activities (including work)
- Similar or less blood loss and need for transfusion
- Shorter hospital stays; an open procedure often requires five to seven days in the hospital while a robotic procedure typically entails a two- or three-day stay
Recovery and Follow-Up Care after Robotic Surgery
Depending on the surgical procedure, thoracic robotic surgery patients spend a night in the intensive care unit so that we can make sure there is no change in heart rhythm. We usually insert a drain to prevent accumulation of fluid in the surgical site, and this is usually removed a day or two after the procedure.
Patients who undergo robotic surgery can often go home sooner than after open surgery. However, for more complex procedures, patients may be required to spend several nights in the hospital.
Once the patient has returned home, a home visiting nurse will come by every day to check the incisions and answer any questions the patient or family members may have. At two weeks post-procedure, patients return to see the surgeon.
We usually do not place specific restrictions on daily routines. We generally recommend that patients do only what feels comfortable; if it hurts, stop. Most patients can return to normal activities within two weeks.