
pmid: 23317939
There is little doubt that robotic surgery is here to stay. The real question is if the technologyhas transitioned fromnovelty and marketing tool to standard of care. The medical literature is rife with midterm results of robotic procedures as varied as mitral valve repair and thyroidectomy or prostatectomy and pancreatic resection. To add to this accumulating knowledge base, Marulli and colleagues now submit their multicenter data on robotically assisted resection of thymoma. Minimally invasive approaches to the mediastinum have been in vogue for well over a decade as technologic advances in imaging and instrumentation have simplified video-assisted thoracic surgery (VATS). Long considered the last bastion of ‘‘bright lights and cold steel,’’ the thorax has succumbed to the same driving force that has shaped much of the rest of surgery, namely, the push to perform equally effective operations through smaller, and less morbid, incisions. To this end, anterior mediastinal operations (ie, thymectomy) classically performed through sternal splitting approaches, now often fall under the purview of VATS. Initially, there was considerable pushback from the traditionalists, who feared that equivalent operations could not be performed without sternotomy, whether to palliate myasthenia gravis (MG) or completely resect thymoma. Now those discussions appear somewhat safely positioned in the rearview mirror. Several excellent studies demonstrate largely equivalent efficacy with much less morbidity and support VATS approaches for thymic surgery. Marulli and colleagues have taken the push for minimal access 1 step farther. Their contribution reviews the outcomes of a 79-patient cohort of robotically assisted thymoma resections. Although some will argue that the reduction in morbidity transitioning from VATS to robotic operations is negligible, intrathoracic instrument articulation and 3-dimensional high-resolution optics clearly permit more elegant and precise operations to be performed robotically. Robotically assisted thymectomy for MG has already been proven safe
Pulmonary and Respiratory Medicine, Male, Thoracic Surgery, Video-Assisted, Robotics, Thymus Neoplasms, Thymectomy, Surgery, Computer-Assisted, Humans, Surgery, Female, Neoplasms, Glandular and Epithelial, Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine, Male, Thoracic Surgery, Video-Assisted, Robotics, Thymus Neoplasms, Thymectomy, Surgery, Computer-Assisted, Humans, Surgery, Female, Neoplasms, Glandular and Epithelial, Cardiology and Cardiovascular Medicine
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