Chapters Transcript Video Minimally Invasive Thoracic Robotic Surgery Thoracic surgeons Jinny Ha and Stephen Yang discuss the future of robotic thoracic surgery at Johns Hopkins. mm. Generally when you talk about surgical operations, there's two main types. There's a traditional open operation where for thoracic surgery would make a larger incision sometimes in between the ribs or up and down the breastbone to gain access to the structures inside the chest cavity. The other forum is minimally invasive surgery. And we make several small incisions, usually about half to three quarters of an inch. Usually there's two or three of these incisions. So one of the incisions will put a tv camera through and then the other incisions will put our instruments through to do what we need to do. Now robotic surgery is much more refined and that the camera that we use actually has two lenses so it gives us a three dimensional view when we're looking at it under the console which is sitting next to the robot. And then the instruments that we use are much more refined as well as the ends of the instruments have these risks, much like the risk that I use, so that when I'm using them in the console it actually turns much like what I do. So robotic surgery is just another step beyond minimally invasive surgery where we're using much more refined technical instruments. Yeah. Mhm. So robotic surgery is different than our traditional approaches. So so we used to use larger incisions to do what we need to do. Whether it was to take out the lung, take out the esophagus, take out large tumors inside the chest. Now we've been making smaller and smaller incisions over time. Um The first step in doing minimally invasive surgery is to be able to see things precisely and use the instrumentation with the robot. Were able to do much more complicated operations these days because the instrumentation is much better with the articulation than the instruments turning much like my wrist. Um and the details of the visualization getting a three dimensional view. There's been a lot of great technical advances with the robot. Compared to conventional video assisted surgery. For patients are robotically assisted surgery needs quicker recovery and less pain. We find that patients are in the hospital a lot shorter. After surgery, patients are a lot less pain, require less harmful medications like narcotics post operatively and patients return to work or normal activity much more quickly compared to patients who undergo a bigger incisions, such as a thorough economy. So we're still learning how to use the robot, even though we've been doing here at Johns Hopkins for 20 years now. This is actually our 20th anniversary of of using the robot. But the technology is going to get better. They're going to get smaller and smaller. The visualization is going to get better. We're seeing better instrumentation so it's going to allow us to do much more complex operations. So currently we are doing what's traditionally done in open operations, but we're able to do a much more difficult operations in the chest. Now, doing airway work, doing esophageal work, taking out large tumors that may be and near the vessels or the nerves. So we're seeing that we don't have to do large operations anymore. This cuts down on the time in the operating room, cuts down on the blood loss and thereby we feel it may also improve cure rates in cancers and that we're getting better margins. We're taking out more lymph nodes and so we're getting a much more complete resection with robotic surgery. Our johns Hopkins thoracic team provides state of the art surgical care. We have a well rounded team with many years of experience and expertise to take on any challenging thoracic pathology. We fully embrace a multidisciplinary approach to our patients care, especially regarding cancer care. We have partnerships of multiple different specialties and work seamlessly together to provide tailored care for each of our patients well for thoracic surgery, we have a dedicated robot, we have one in our operating room, we have 100% access to it, so we do not need to schedule it, so uh we have it as common as some of our other instruments. Uh We can do robotics every day of the week. We actually do some cases on Saturdays as well. Um but as I said earlier, uh we do have the experience with robotic surgery going back to about 20 years, so I think that's something that most other programs would not have. Mhm. Mhm. Created by Related Presenters Stephen Yang, M.D. Associate Vice Chair for Faculty Development Professor of Surgery Dr. Stephen C. Yang is a professor of surgery and medical oncology at Johns Hopkins University School of Medicine and The Johns Hopkins Hospital.