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Major lung resections by minimally invasive surgery (MIS) has been acknowledged as an effective technique for treatment of early stage lung cancer. Multiple publications have demonstrated the safety and clear benefits of this approach (video thoracic surgery or VTS) over thoracotomy. However, concerns still remain especially in terms of lack of standardization of operative technique, technical limitations (impaired vision, restricted instrument manoeuvrability, unstable camera platform), and poor ergonomics for surgeon. Recently, robots have been introduced into surgical practice in an attempt to facilitate surgical performance. In order to address some of these limitations, a robotic surgical system (da Vinci, Intuitive Surgical, Sunnyvale, CA, US) has been developed with 3-dimensional, high-definition imaging, instrumentation with seven degrees of freedom, and a master–slave surgical cart. This chapter describes technical aspects and assimilation of this new technique into the practice of thoracic surgeon and attempts to answer some questions: How do we assure quality and safety in terms of proper oncologic surgery?
KeywordsAssistant Surgeon Robotic Surgical System Lower Lobectomy Mechanical Stapler Anterior Incision
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