Robotic intraoperative tracheal repair during retrosternal malignant goiter excision: an anesthetic challenge

Ankur Verma; Shubhashish Biswas; Pooja Singh; Tarun Tyagi; Pankaj Khatri; Tushar Gupta; Surender Kumar Dabas

doi:10.18203/2320-6012.ijrms20232452

Authors

Ankur Verma Department of Onco-Anesthesiology, BLK-Max Hospital, New Delhi, India
Shubhashish Biswas Department of Onco-Anesthesiology, BLK-Max Hospital, New Delhi, India
Pooja Singh Department of Onco-Anesthesiology, BLK-Max Hospital, New Delhi, India
Tarun Tyagi Department of Onco-Anesthesiology, BLK-Max Hospital, New Delhi, India
Pankaj Khatri Department of Onco-Anesthesiology, BLK-Max Hospital, New Delhi, India
Tushar Gupta Department of Onco-Anesthesiology, BLK-Max Hospital, New Delhi, India
Surender Kumar Dabas Department of Surgical Oncology and Robotic Surgery, BLK-Max Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232452

Keywords:

Robotic surgery, Tracheal repair, Retrosternal goiter, Cook’s airway

Abstract

Thyroidectomy is the treatment of choice for large retrosternal goiters. These tumors often are large enough to require thoracotomy. Robotic surgery can help in avoiding thoracotomy and its associated post operative complications. Rarely, such tumors and their surgery can be complicated by tracheal tears. Such tears, especially those near the carina are difficult to repair and often require open thoracotomy. We described such a case where we avoided open thoracotomy and instead performed a minimally invasive robotic repair of tracheal tear. The maintenance of ventilation during this robotic repair was critical. A combination of several airway devices was used to allow the complex surgical repair to be executed without affecting ventilation.

Metrics

Metrics Loading ...

References

Zhao Z, Zhang T, Yin X, Zhao J, Li X, Zhou Y. Update on the diagnosis and treatment of tracheal and bronchial injury. J Thorac Dis. 2017;9:50-6.

Tartaglia N, Iadarola R, DiLascia A, Cianci P, Fersini A, Ambrosi A. What is the treatment of tracheal lesions associated with traditional thyroidectomy? Case report and systematic review. World J Emerg Surg. 2018;13:15.

Grewal HS, Dangayach NS, Ahmad U, Ghosh S, Gildea T, Mehta AC. Treatment of tracheobronchial injuries: a contemporary review. Chest. 2019;155:595-604.

Brito JMT. Robotic assisted repair of large iatrogenic tracheal laceration with ECMO support. doi:10.25373/ctsnet.21568212.v1. Available at: https://www.ctsnet.org/article/robotic-assisted-repair-large-iatrogenic-tracheal-laceration-ecmo-support. Accessed on 15th May 2023.

Marano A, Palagi S, Pellegrino L, Borghi F. Robotic intraoperative tracheobronchial repair during minimally invasive 3-stage esophagectomy. J Chest Surg. 2021;54:154-7.

Melinte A, Steriade A, Pavel G, Ceausescu C, Dobritoiu F, Copaescu C. Robotic assisted thoracoscopic repair of iatrogenic tracheal rupture. Chirurgia (Bucur). 2022;117:698-705.

Paek SH, Kang KH, Park SJ. A comparison of robotic versus open thyroidectomy for papillary thyroid cancer. Surg Laparosc Endosc Percutan Tech. 2018;28:170-3.

Kim EB, Cho JW, Lee YM, Sung TY, Yoon JH, Chung KW, et al. Postsurgical outcomes and surgical completeness of robotic thyroid surgery: a single surgeon’s experience on 700 cases. J Laparoendosc Adv Surg Tech. 2018;28:540-5.