Key result
Robotic-assisted left upper lobectomy safely preserves the LIMA graft without complications after prior CABG.
Why the study?
Robotic lung resection after CABG poses technical challenges when the left internal mammary artery adheres to the left upper lobe, risking catastrophic myocardial ischaemia.
Case Report (n=1)
Robotic-assisted lung resection can be safely performed in patients with prior CABG by meticulously dissecting and preserving the LIMA graft.
Robotic LIMA preservation technique during left upper lobectomy is feasible in post-CABG patients; hypothesis-generating and requires prospective validation.
Robotic-assisted lung resection in patients with prior coronary artery bypass grafting presents unique technical challenges, particularly when the left internal mammary artery is adherent to the left upper lobe. Injury to this graft can result in catastrophic myocardial ischaemia. This video tutorial describes a robotic technique for safe identification and dissection of the left internal mammary artery during left upper lobectomy. The case involves a 78-year-old man with early-stage squamous cell carcinoma of the left upper lobe and a history of coronary artery bypass grafting using the left internal mammary artery. A robotic approach was selected to facilitate meticulous dissection under high-definition three-dimensional visualization. The tutorial focuses on stepwise exposure of the graft, controlled adhesiolysis, and preservation of graft integrity while completing anatomical lobectomy and lymph node dissection. The procedure was completed without intraoperative complications. We aim to provide practical guidance for thoracic surgeons performing robotic lung resections in patients with prior mammary artery grafts, highlighting key anatomical landmarks, dissection strategies, and technical precautions to minimize risk.
No takes yet. Share an insight, caveat, or question.
Abdelghafar et al. (2026) conducted a case report in Early-stage squamous cell carcinoma of the left upper lobe with prior CABG using the left internal mammary artery (n=1). Robotic-assisted left upper lobectomy with LIMA dissection was evaluated on Intraoperative complications. Robotic-assisted left upper lobectomy with meticulous dissection of the left internal mammary artery was completed safely without intraoperative complications in a patient with prior CABG.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: