ロボット支援下肺切除術における気管支・血管形成導入への取り組み

Establishing Bronchial and Vascular Reconstruction in Robot-assisted Pulmonary Thoracic Surgery

ロボット支援下肺切除術は，高精細な三次元視野と高い操作精度を有する鉗子操作により，安全かつ精緻な手術操作を可能にしてきた．当院ではロボット支援下肺葉切除に加え，複雑区域切除にも積極的に取り組み，安全性を重視した手術手技の確立をすすめてきた．近年は術前免疫導入療法の普及に伴い，進行肺癌に対する外科切除の機会が増加し，気管支形成や血管形成といった高難度再建をロボット支援下に行う報告も増えている．

Robot-assisted thoracic surgery has enabled safe and precise surgical procedures by providing a high-definition three-dimensional visual field and highly dexterous instrument manipulation. At our institution, we have actively performed robot-assisted thoracic surgery, including complex segmentectomy, with a continuous emphasis on establishing safe and reliable surgical techniques. In recent years, with the widespread adoption of neoadjuvant immunotherapy, the number of surgical resections for advanced lung cancer has increased, and reports of robot-assisted high-complexity reconstructions, such as bronchoplasty and vascular reconstruction, have also become more frequent. Building on the reconstructive techniques established through conventional open thoracotomy, we are planning to introduce robot-assisted reconstructive surgery at our institution. During this process, we aim to faithfully reproduce the principles of open surgical techniques within the robotic setting while achieving an optimal balance between safety and minimal invasiveness. In this article, we provide an overview of our approach to this endeavor.