呼吸器外科ロボット手術の現状

抄録

The National Health Insurance (NHI) has started to cover robot-assisted thoracoscopic surgery (RATS) for malignant lung tumors (LTs) and mediastinal tumors in 2018 in Japan. The number of domestic RATS is increasing rapidly in thoracic surgery. Our department has started performing RATS in April 2012 as clinical research. A total of 214 patients received RATS between April 2012 and February 2020. After NHI coverage, all cases judged to be resectable by video-assisted thoracoscopic surgery (VATS) were performed as RATS. One hundred thirty-eight cases were LTs, 74 cases were mediastinal tumors, and 4 cases were LTs with mediastinal tumors. As RATS procedures have several variations, we performed RATS lobectomy with four-port incisions and a 3-cm utility thoracotomy or a CO2 insufflation combined assistant port and RATS resection of mediastinal tumors with three-port incisions by CO2 insufflation. Only 1 patient with thymoma converted to VATS. In the near future, RATS will become the best surgical technique for open surgery and/or VATS in the field of thoracic surgery. This new surgical technique is beneficial both to our patients as well as to the surgeons.