Diagnostic Techniques

what is it?

Staging Information

has it spread?

Surgical Management

remove it

Diagnosis of Lung Cancer

Bronchoscopy

Utilizes a lighted scope to visualize and inspect the lungs thru the trachea. This includes specialized techniques like Navigational Bronchoscopy and Endobronchial Ultrasound. This allows us to use specialized instruments to find the nodule and perform the biopsy.

CT

Biopsy

This method utilizes a cat scanner to localize the nodule and an interventional radiologist then guides a needle thru the chest wall to obtain tissue for diagnostic testing

Surgery

This is the most invasive apporach and requires general anesthesia. Several small incisions are made on the chest and robotic instruments are inserted to visualize the nodule. The nodule is removed and evaluaed by the pathologist. If they identify cancer, a full removal of the remaining lobe of the lung is undertaked to remove all the cancer. In addition lymph nodes are removed.

PET SCAN

PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

This test can help determine if a nodule is more likely a cancer and if there is any evidence of spread to other parts of the body.

THORACIC ROBOT ASSISTED SURGERY

The da Vinci® Surgical System enables surgeons to perform operations through a few small incisions and features several key features, including:

Magnified vision system that gives surgeons a 3D HD view inside the patient’s body
Ergonomically designed console where the surgeon sits while operating
Patient-side cart where the patient is positioned during surgery
Wristed instruments that bend and rotate far greater than the human hand

Lobectomy (Non-small cell lung cancer)

If you’ve been diagnosed with non-small cell lung cancer, your doctor will discuss the condition with you and the best plan of action. He/she may suggest surgery to remove part of your lung (lobe). The operation is called a lobectomy. It can be done using open surgery or minimally invasive surgery.

Open Surgery

Open surgery is done through a long chest incision (cut). Your surgeon may also need to spread your ribs to reach your lung and chest cavity.

Minimally Invasive Surgery

One minimally invasive surgery option is thoracoscopy, also called video-assisted thoracic surgery or VATS. Doctors insert a tiny camera and surgical instruments into your chest through small incisions. The camera sends images to a video screen to guide doctors as they operate.

Robotic Surgery

Another minimally invasive option for patients facing lobectomy is robotic-assisted da Vinci Surgery. Like VATS, robotic surgery uses small incisions. Thru these incision robotic instruments and a camera are inserted to conduct the operation.

SHORTER HOSPITAL STAY

SMALLER INCISIONS

LESS PAIN AFTER SURGERY

MORE COMPLETE CANCER SURGERY

Why Robotic Surgery?

The da Vinci System features a magnified 3D HD vision system and special instruments that bend and rotate far greater than the human hand. These features enable surgeons to operate with enhanced vision, precision, and control. Early clinical data suggests Robotic Lobectomy may offer the following potential benefits compared to open surgery:

Shorter hospital stay1,2,3,4
Shorter chest tube duration1,2,5
Less or similar rate of blood loss and/or transfusions1,2,5
Smaller incisions for less scarring

Robotic Lobectomy may offer the following potential benefits compared to VATS:

Shorter/similar hospital stay2,6

Robotic Lobectomy may offer the additional potential benefit:

Low mortality (death) rate1,4,5

Your doctor controls the da Vinci System, which translates his/her hand movements into smaller, precise movements of tiny instruments inside your body.

The da Vinci System has brought minimally invasive surgery to more than 3 million patients worldwide. da Vinci technology – changing the experience of surgery for people around the world.

Risks & Considerations Related to any Pulmonary Resection (removal of part of lung): air leaks from lungs, lung infection, lengthy time on a breathing machine of 48 hours or more, abnormal/irregular heartbeat, breathing tube needs to be re-inserted, abnormal path between lung airways and lining, lung failure lymph fluid collects around lungs, abnormal vocal cord function.

Cerfolio RJ, et al. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. The Journal of Thoracic and Cardiovascular Surgery.2011;142(4)740-746.
Farivar AS, et al. Comparing Robotic Lung Resection With Thoracotomy and Video-Assisted Thoracoscopic Surgery Cases Entered Into The Society of Thoracic Surgeons Database. Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 2014:9(1):1-6.
Kent M, et al. Open, Video-Assisted Thoracic Surgery, and Robotic Lobectomy: Review of a National Database. The Annals of Thoracic Surgery. 2013: 97(1): 236-244.
Oh DS, et al. Early Adoption of Robotic Pulmonary Lobectomy: Feasibility and Initial Outcomes. The American Surgeon.2013: 79: 175-180.
Adams RD, et al. Initial multicenter community robotic lobectomy experience: comparisons to a national database. The Annals of Thoracic Surgery. 2014:97(6): 1893–1900 http://dx.doi.org/10.1016/j. athoracsur.2014.02.043.
Jang HJ, et al.; Comparison of the Early Robot-Assisted Lobectomy Experience to Video-Assisted Thoracic Surgery Lobectomy for Lung Cancer. 2011: Innovations • Volume 6, Number 5, September/October 2011.