Robotic Right Upper Sleeve Lobectomy With Rotational Azygous Vein Flap
In this video, the authors demonstrate a robotic right upper sleeve lobectomy with a rotational azygos vein flap. The patient was a 68-year-old female presenting with a right supra-hilar non-small cell lung cancer, which caused obstructive atelectasis of the right upper lobe (RUL). A computed tomography (CT) scan showed the RUL mass involving the RUL bronchus, adjacent to the bronchus intermedius, near the bifurcation of the right main stem bronchus.
For the surgery, the patient was placed in a left lateral decubitus position, and the ports—four robotic ports and one assist port—were inserted in standard fashion for an RUL lobectomy. The initial dissection involved lysis of adhesions due to the presence of fibrous bands near the upper lobe, which restricted its mobility. Next, the inferior pulmonary ligament was released. Any station 9 nodes that were encountered were also removed and sent to pathology.
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