Article Abstract

Complete portal robotic sleeve resection of the bronchus intermedius

Authors: Raul Caso, Thomas J. Watson, M. Blair Marshall

Abstract

Parenchymal sparing sleeve resection of the bronchus intermedius has been performed for isolated strictures of the bronchus intermedius. We report a complete portal robotic sleeve resection of the bronchus intermedius in a patient with a benign tumor. A 68-year-old woman found to have an endobronchial lesion and underwent endoscopic resection. Cautery artifact obscured the diagnosis but the pathology was suspicious for carcinoma. The clinical picture was more suggestive of a benign lesion. We performed a robotic sleeve resection of the bronchus intermedius for definitive diagnosis and management of this lesion. The airway was divided just below the upper lobe takeoff and just above the middle and superior segmental bronchi. The diagnosis was confirmed as benign adenoma. The airway was reconstructed in an end-to-end fashion with a running suture. The patient was discharged on postoperative day 5. There were no anastomotic or other complications. We have previously reported this technique with an open approach for benign strictures of the bronchus intermedius. A minimally invasive approach is feasible and useful in the management of benign pathology of the bronchus intermedius.