Robotic Surgery
P re f a c e Robotic Surgery
Bernard J. Park, MD, FACS Editor
the learning curve involved in learning new techniques, and the stunning initial cost of the system. However, there has been interest building steadily in the role of telerobotics in the surgical management of thoracic disease as minimally invasive approaches fast become the standard of care. This issue of the Thoracic Surgery Clinics attempts to review the technical aspects of several index thoracic procedures, such as anatomic lung resection, esophageal procedures, and approaches to mediastinal tumors. In addition, there is review of long-term results of robotic surgical treatment of early lung cancer and myasthenia gravis, as well as a candid look at the benefits and pitfalls of robotic technology in the field of minimally invasive surgery as a prelude to more in-depth assessments of the appropriate utilization of this complex technology.
Thorac Surg Clin 24 (2014) ix http://dx.doi.org/10.1016/j.thorsurg.2014.02.013 1547-4127/14/$ – see front matter Ó 2014 Published by Elsevier Inc.
Bernard J. Park, MD, FACS Chief of Thoracic Surgery Department of Surgery Hackensack University Medical Center Hackensack, NJ 07601, USA E-mail address: [email protected]
thoracic.theclinics.com
Over the past three decades there has been an explosion of advances in the field of minimally invasive surgery, including innovative new procedures, expanded indications, improved optics, and instrumentation. Perhaps one of the most radical and controversial recent advances has been the development of the master-slave, telerobotic surgical system and its widespread adoption for certain procedures, such as laparoscopic prostatectomy and hysterectomy. Interestingly, telerobotic surgery was originally conceived and FDA-approved for closed chest cardiac surgery and yet it has not become widely adopted for revascularization or valve repair despite the fact that the robotic platform is unusually well-suited to a narrow surgical space such as the anterior mediastinum. Instead, the robotic platform has become the approach of choice for pelvic procedures in urology, gynecology, and colorectal surgery because of immediate, readily apparent technical advantages of three-dimensional vision and seven degrees of freedom of instrumentation. Robotics has not had the same pace of implementation in general thoracic surgery perhaps because of skepticism regarding the interval benefit over nonrobotic VATS or laparoscopic procedures,
P re f a c e Robotic Surgery
Bernard J. Park, MD, FACS Editor
the learning curve involved in learning new techniques, and the stunning initial cost of the system. However, there has been interest building steadily in the role of telerobotics in the surgical management of thoracic disease as minimally invasive approaches fast become the standard of care. This issue of the Thoracic Surgery Clinics attempts to review the technical aspects of several index thoracic procedures, such as anatomic lung resection, esophageal procedures, and approaches to mediastinal tumors. In addition, there is review of long-term results of robotic surgical treatment of early lung cancer and myasthenia gravis, as well as a candid look at the benefits and pitfalls of robotic technology in the field of minimally invasive surgery as a prelude to more in-depth assessments of the appropriate utilization of this complex technology.
Thorac Surg Clin 24 (2014) ix http://dx.doi.org/10.1016/j.thorsurg.2014.02.013 1547-4127/14/$ – see front matter Ó 2014 Published by Elsevier Inc.
Bernard J. Park, MD, FACS Chief of Thoracic Surgery Department of Surgery Hackensack University Medical Center Hackensack, NJ 07601, USA E-mail address: [email protected]
thoracic.theclinics.com
Over the past three decades there has been an explosion of advances in the field of minimally invasive surgery, including innovative new procedures, expanded indications, improved optics, and instrumentation. Perhaps one of the most radical and controversial recent advances has been the development of the master-slave, telerobotic surgical system and its widespread adoption for certain procedures, such as laparoscopic prostatectomy and hysterectomy. Interestingly, telerobotic surgery was originally conceived and FDA-approved for closed chest cardiac surgery and yet it has not become widely adopted for revascularization or valve repair despite the fact that the robotic platform is unusually well-suited to a narrow surgical space such as the anterior mediastinum. Instead, the robotic platform has become the approach of choice for pelvic procedures in urology, gynecology, and colorectal surgery because of immediate, readily apparent technical advantages of three-dimensional vision and seven degrees of freedom of instrumentation. Robotics has not had the same pace of implementation in general thoracic surgery perhaps because of skepticism regarding the interval benefit over nonrobotic VATS or laparoscopic procedures,
