A team of robotic thoracic surgeons from St. Luke’s-Global City has recently performed the country’s first robotic lung resection on a 61 year-old female patient who was discovered to have a 3.5cm mass in the left upper lobe of her lungs.
The mass was suspected to be malignant after doing an extensive work-up, including a PET/CT scan. Using the third-generation Da Vinci Si surgical system, the only robotic surgical machine of its kind available in the Philippines, the St. Luke’s-Global City surgical team performed a resection of the left upper lobe of the lung with complete mediastinal lymph node dissection.
The team was headed by Dr. Edmund E. Villaroman, and assisted by Dr. Karlos R. Aleta and Dr. Mariam Grace A. Delima. All three surgeons are pioneers in advanced minimally invasive thoracic surgery in the Philippines. They have had extensive training in video-assisted thoracic surgery as well as robotic surgery in various institutions locally and abroad.
After the surgery, the patient had a quick recovery and minimal postoperative pain. “The chest tube of the patient was removed on the third day and was discharged on the fifth day,” said Dr. Villaroman.
“She was not taking any more pain medication after a week and she was quickly able to resume to her usual activities,” he added.
Traditionally, patients who undergo lung resection are given the option of either open surgery or video-assisted thoracic surgery (VATS). Open surgery requires forcefully opening the space in between the ribs to gain access to the chest cavity. The trauma to the chest wall and the possible rib fracture result in severe postoperative pain, longer recovery, and greater possibility of complications.
On the other hand, VATS is performed using one to four small port incisions and utilizes 2D imaging and long endoscopic instruments. A major limitation of VATS, however, is the difficulty in maneuvering these long instruments with limited articulation, thereby putting a lot of trauma to the port sites.
Compared to VATS, robotic thoracic surgery might require an additional port incision but the blunt trauma to these incisions is far less than in VATS.
Apart from lower incidence of pain, robotic surgery offers other advantages. Dr. Villaroman explains, “Robotic surgery is beneficial in performing surgeries in a confined space like the chest. The Da Vinci Endowrist technology provides a wider range of motion than the surgeon’s hands. Complex procedures can therefore be performed precisely even in hard-to-reach areas not normally accessible by the hand or even with laparoscopic instruments.” Furthermore the 3D HD camera provides unparalleled clarity, depth of vision and 10x magnification resulting in better surgical precision.
Other thoracic conditions that can be done robotically include thymectomy (removal of the thymus), esophagectomy (removal of the esophagus), and removal of other chest tumors. Patients in the Philippines now need not go abroad to seek this kind of minimally invasive procedure.
To date, St. Luke’s-Global City has performed more than 500 robotic procedures on urologic, gynecologic, and general surgery cases with excellent outcomes.
For more information on robotic surgery, you can reach the St. Luke’s Minimally Invasive and Robotic Surgery Center at (632) 7230101/0301 ext. 4192 (Quezon City) and (632) 7897700 ext. 2116 (Global City), or email mirsc@stluke.com.ph or mirsc.gc@stluke.com.ph.
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