Robotic resection of inflammatory tumour

We present a video showing techniques of robotic sleeve lobectomy in a case of inflammatory tumour of left main bronchus. Inflammatory tumour is a rare condition that is encountered in South east Asia. Usually there is a background of tuberculosis. This causes intense adhesions and inflammatory reaction making surgical resection difficult. Our patient presented with evidence of left main bronchus Endobronchial tumour with distal collapse. Bronchoscopic biopsy confirmed this to be a inflammatory tumour. We performed a Robotic resection of the tumour. During surgery we did a left upper lobectomy. We performed a bronchotomy and opened the left upper lobe bronchus. We then delivered the tumour into the left upper lobe and completed the upper lobectomy. This enabled us to save the lower lobe. The stump of the left upper lobe bronchus was sutured using robotic techniques. Post operative radiology confirmed good expansion of lower lobe. Follow up at one year confirmed bronchoscopic and radiological freedom from recurrence with continued good expansion of left lower lobe and good pulmonary function tests. Robotic is an additional tool in the armamentarium of the thoracic surgeon. It gives good vision in inflammatory conditions. It facilitates dissection of dense adhesions with minimal blood loss. Sleeve resection and sleeve lobectomy is possible due to ease of suturing with the robotic platform. This is our operation of choice in the complex thoracic surgery cases.