Robotic-assisted left carinal sleeve pneumonectomy with extracorporeal membrane oxygenation support for adenoid cystic carcinoma

Abstract

Sleeve pneumonectomy is one of the most challenging thoracic procedures as a result of airway reconstruction complexity. It is indicated for central tumors involving the main bronchus, carina, or distal trachea.1 This procedure has traditionally been performed via thoracotomy, sternotomy, or clamshell incision for access to the lower trachea and carina. Hybrid techniques combining thoracotomy and video-assisted thoracic surgery (VATS), as well as fully VATS-based approaches, have also been described.2,3 To date, no fully robotic approaches for this procedure have been documented. In this report, we describe the technical aspects of a left carinal sleeve pneumonectomy for adenoid cystic carcinoma of the lung using a robotic-assisted thoracic surgery (RATS) approach with extracorporeal membrane oxygenation (ECMO) support, highlighting its feasibility and safety.