VATS Versus Robotic Anatomic Pulmonary Resection in a High-Volume Institution: Cost and Outcomes Analysis.

Objective: This study evaluates the impact of transitioning from video-assisted thoracoscopic surgery (VATS) to robot-assisted thoracoscopic surgery (RATS) on patient outcomes and costs, based on the experience of a single surgeon at a quaternary center.

Methods: We reviewed patients who underwent anatomic lung resections by a single surgeon between 2015 and 2022, excluding nonanatomic resections and those involving robotic bronchoscopy followed by resection. We compared baseline characteristics, short-term outcomes, and costs between the VATS (2015 to 2018) and robotic (2018 to 2022) groups.

Integrated Cardiothoracic Surgery Residency Programs Largely Produce Cardiac Surgeons-Is the General Thoracic Surgeon an Endangered Species?

IntroductionIntegrated cardiothoracic surgery residency programs were introduced in 2008 in response to a decline in cardiothoracic surgery trainees. Since their inception, the number of integrated programs has grown, while the availability of independent fellowships has diminished. We hypothesize that the rise in integrated residencies will adversely affect the number of general thoracic surgery graduates.

Standardized Approach to Robotic-Assisted Esophagectomy.

Esophagectomy is the standard treatment for localized esophageal cancer. However, this procedure is associated with significant morbidity and mortality. There has been a growing shift toward minimally invasive techniques, which have been shown to reduce perioperative complications, shorten hospital stays, and enhance patient satisfaction while adhering to oncologic principles.

Combining Robotic Navigational Bronchoscopy and Lung Resection Into a Single Anesthetic Event: Cost-Effectiveness, Wait Times, and Outcomes.

Background: Delay from diagnosis to resection in non-small cell lung cancer negatively affects survival. Single-anesthesia robotic navigational bronchoscopy with biopsy and lung resection (SABR) was developed to mitigate delay. We report outcomes, wait times, and cost effectiveness of this approach vs staggered robotic navigational bronchoscopy followed by resection.

1121 Shape-sensing Robotic-assisted Bronchoscopic Biopsies: Diagnostic Yield and Surgical Implications.

Background: This study sought to evaluate a single institution's experience using shape-sensing robotic-assisted bronchoscopy (ssRAB) for the diagnosis and management of pulmonary nodules.

Methods: All patients underwent ssRAB between September 2020 and May 2024. A procedure was defined as diagnostic if a benign or malignant result was obtained.

National trends in operative approach to esophagectomy: utilization rates, outcomes, and overall survival.

Background: Although open esophagectomies (OE) have traditionally been favored, minimally invasive approaches are increasingly utilized and associated with improved outcomes. We investigated the adoption rates of robotic-assisted minimally invasive esophagectomy (RAMIE) and minimally invasive esophagectomy (MIE) compared with OE. Utilization rates by surgical approach, post-operative outcomes, and overall survival were analyzed.

Robotic navigational bronchoscopy in a thoracic surgery practice: Leveraging technology in the management of pulmonary nodules.

Objectives: Robotic navigational bronchoscopy is increasingly used to improve diagnostic yield for pulmonary nodules compared with the 50% to 60% obtained by standard bronchoscopy; however, safety and efficacy data are limited to small series. The aim of this study was to evaluate diagnostic yield and clinical outcomes in a large multisurgeon single-center cohort.

Methods: All patients who underwent robotic navigational bronchoscopy and biopsy from September 2020 to October 2022 were identified from a prospective institutional registry.

Robotic totally endoscopic triple bypass with bilateral internal mammary arteries and two different anastomotic techniques.

Robotic totally endoscopic coronary artery bypass (TECAB) offers several advantages over conventional sternotomy coronary artery bypass grafting. TECAB allows the increased use of bilateral internal mammary artery grafts independent of gender, body mass index or diabetes, minimizes the risk of wound infection, decreases the length of hospital stay, and improves the postoperative quality of life. Off-pump beating heart TECAB has been used to offer one or two grafts generally on the anterior wall.

A model for continued LVAD patient success: A 4-year readmission-free HeartMate 3 postoperative course.

Unplanned readmissions frequently occur following the implantation of a durable left ventricular assist device (LVAD) due to complications such as gastrointestinal bleeding and driveline infection. There is a paucity of literature describing the incidence of unplanned readmission in patients with a HeartMate 3 (HM3) Left Ventricular Assist System. In this report, we present the successful outcome of a patient with an HM3 LVAD who has experienced no unplanned readmissions in the 4-year post-implant phase.

Outpatient Thoracoscopic Mediastinal Biopsy: A Safe and Cost-Effective Approach.

Background: Most mediastinal biopsy patients are managed with an overnight inpatient stay and chest drainage. We sought to determine the safety, accuracy, and cost of outpatient thoracoscopic mediastinal biopsy by reviewing operative techniques, perioperative outcomes, and admission charges for this procedure.

Methods: This single-institution retrospective study reviewed all patients who underwent elective thoracoscopic mediastinal biopsy between 2012 and 2017.

Update on Lung Cancer Screening.

Over the past 10 years, there has been substantial progress in the study and implementation of lung cancer screening using low-dose computed tomography (LDCT). The National Lung Screening Trial, the recently reported NELSON (NEderlands-Leuvens Longkanker Screenings ONderzoek) trial, and other European trials provide strong evidence for the efficacy of LDCT to reduce lung cancer mortality. This has resulted in the United State's Preventative Task Force and numerous professional medical societies adopting lung cancer screening recommendations.

Outcomes in Patients with Helicobacter pylori Undergoing Laparoscopic Sleeve Gastrectomy.

Background: In vertical sleeve gastrectomy (VSG), the majority of the stomach is resected and much of the tissue colonized with Helicobacter pylori and the bulk of acid producing cells are removed. In addition, the effect of H. pylori colonization of the stomach of patients undergoing stapling procedures is unclear.