Page 6 - Read Online

Gharagozloo et al. Mini-invasive Surg 2020;4:57 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.44

Review Open Access

Technique of robotic lobectomy III: control of major
vascular injury, the 5 “P”’s

Farid Gharagozloo, Mark Meyer

Center for Advanced Thoracic Surgery, Global Robotics Institute, Advent Health Celebration, University of Central Florida,
Celebration, FL 34786, USA.
Correspondence to: Dr. Farid Gharagozloo, Center for Advanced Thoracic Surgery, Global Robotics Institute, Advent Health
Celebration, University of Central Florida, 400 Celebration Place, Celebration, FL 34786, USA.
E-mail: farid.gharagozloo.md@adventhealth.com
How to cite this article: Gharagozloo F, Meyer M. Technique of robotic lobectomy III: control of major vascular injury, the 5 “P”’s.
Mini-invasive Surg 2020;4:57. http://dx.doi.org/10.20517/2574-1225.2020.44
Received: 29 Apr 2020 First Decision: 8 Jun 2020 Revised: 8 Jun 2020 Accepted: 24 Jun 2020 Published: 1 Sep 2020

Academic Editor: Giulio Belli, Noriyoshi Sawabata Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Robotic Lobectomy has been evolving over the past decade and has been shown to be an oncologically efficacious
procedure. Although robotic lobectomy is performed more frequently in centers around the world, it accounts
for a small percentage of all lobectomies. One of the major causes of reluctance to adopt robotic lobectomy and
segmentectomy procedures by surgeons is the fear of bleeding complications, as well as the lack of a standardized
reproducible approach to these potentially catastrophic events. This paper outlines a proven strategy for control
of bleeding complications during robotic lobectomy and segmentectomy procedures: the 5 “P”’s of Prevention,
Preparedness, Poise, Pressure, and Proximal Control.

Keywords: Robotic, lobectomy, bleeding, upper lobectomy, middle lobectomy, lower lobectomy, lobectomy,
conversion, lung cancer, 5 “P”’s

INTRODUCTION
Although robotic lobectomy is performed more frequently in centers around the world, it accounts for a
small percentage of all lobectomies. One of the determinants for the lower level of adoption of the robotic
lobectomy and segmentectomy procedures is concern about catastrophic bleeding complications, as well as
a reproducible strategy for the control of bleeding.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.misjournal.net