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Robotic Pleurectomy and Pleurodesis

I'm presenting a case of a robotic

assisted right apical wedge resection

the rectum employ reduces this is a 33

year old female with a recurrent

right-sided pneumothorax patient had two

episodes of new motors in the past the

case was performed at Providence

Regional Medical Center in Everett

Washington the surgeons were myself luis

fernando burton and daughter Kimberly

Costas

we use a DaVinci x-eye with the three

working ports one for the camera one for

a carrier and one for the spatula most

of the time and one assistant port I

start with inspection of the apex and

removing some blood clot over there I

inspected the upper lobe completely in

the middle in lower lobe you can see a

small division in the memory vessels

behind

it's the inferior aspect you can see the

inferior vena cava so it's more adhesion

over there

there was no blebs identified but we

still performed a small wedge resection

of the apical segment it's my assistant

placing the stapler over there

there's more in Korea sections just to

promote scar formation

it's completion of the wedge resection

and that's the step of procedure if the

director

you can see how helpful Ducati er now he

is to just bring the pleura down I use a

combination between electric artery in

blunt dissection and I strip the pleura

all the way to the apex

this is more bleeding over there can see

how well I can control the bleeding

in the visualization which the 3d is

just now perfect

I'm just removing the blur over there

remove the specimen

then the next step are going to proceed

with her

the reduce is using a Bava scratch pad

start posteriorly and just and I scrape

the entire surface of the pleura

but surely towards the interior aspect

now and go as low down to that diaphragm

as I I can guess at the end now have

your things that I braided place the

chest to be rings effect along that's

the end of the procedure

you