Robot-assisted tracheal carina resection and reconstruction for adenoid cystic carcinoma: a case report

BACKGROUND: Carinal reconstruction is the primary surgical intervention for tracheal tumors involving the tracheal carina. However, the complexity of airway management and the challenges associated with invasive carina reconstruction significantly increase its operative difficulty. CASE PRESENTATION: A 48-year-old male patient presented with a 6-month history of persistent cough. Cervical and thoracic computed tomography (CT) imaging, along with bronchoscopic biopsy, confirmed a diagnosis of tracheal adenoid cystic carcinoma (TACC), with the tumor extending to the tracheal carina and left main bronchus. The patient subsequently underwent robot-assisted carinal resection and reconstruction using a three-port approach under extracorporeal membrane oxygenation (ECMO) support. Intraoperative oxygen saturation remained stable, and the postoperative course was uneventful. CONCLUSIONS: This case suggests that that the combination of ECMO support and robotic assistance facilitates adequate oxygenation and enables a minimally invasive, safe and efficient approach to carinal resection and reconstruction. Further studies and broader clinical experience across multiple centers are required to validate the safety and practicality of this technique.