Description of Event or Problem · 1
A SINGLE-LUMEN ENDOTRACHEAL TUBE WAS PLACED BY ANESTHESIA. THE MASS WAS DENSELY ADHERENT OR INVADING THE LEFT UPPER LOBE OF THE LUNG. AS SUCH, MULTIPLE FIRINGS OF THE 45 MM BLACK-COLORED UNIVERSAL GIA STAPLER WERE USED TO PERFORM A LEFT UPPER LOBE WEDGE RESECTION OF THE LUNG. GIVEN THE DENSE ADHESIONS OF THE THYMOMA ONTO THE PERICARDIUM, A WIDE PERICARDIAL RESECTION WAS PERFORMED. THE RADICAL THYMECTOMY AND MEDIASTINAL MASS RESECTION WERE COMPLETED. COMPLEXITY: THE OPERATION WAS MORE COMPLEX THAN A STANDARD MEDIASTINAL MASS RESECTION FOR THE FOLLOWING REASONS: THE PATIENT HAD AN ANTERIOR MEDIASTINAL THYMOMA WHICH WAS INVADING THE PERICARDIUM AND THE LEFT UPPER LOBE OF THE LUNG. AS SUCH, ALTHOUGH MOST OF THE OPERATION WAS PERFORMED IN A MINIMALLY INVASIVE FASHION WITH THE USE OF THE ROBOT OR VIDEO-ASSISTED THORACIC SURGERY, ULTIMATELY, DUE TO THE DENSE ADHESIONS AND INVASION OF THE TUMOR INTO THE LEFT UPPER LOBE OF THE LUNG AND PERICARDIUM, AN OPEN APPROACH WITH A PARTIAL UPPER STERNOTOMY WAS REQUIRED TO PERFORM A COMPLETE RESECTION. ACTION: DAVINCI SUPPORT TEAM CALLED AND RESPONDED IN REAL TIME TO THIS EVENT. REUSABLE STAPLER TO BE SEQUESTERED FOR REVIEW. UPDATE TO BE PROVIDED BY DAVINCI TEAM POST EVALUATION OF THIS ROBOT. PER THE CIRCULATING RN WHO REPORTED THIS EVENT, THE PERI-CARDIUM WAS INVOLVED IN THIS PROCEDURE FOR RESECTION AND THE POTENTIAL FOR THIS PROCEDURE TO CONVERT TO AN OPEN CASE WAS A HIGH PROBABILITY.