Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report

Abstract Background Robot-assisted Thoracic Surgery (RATS) is well-established for complex minimally invasive thoracic surgery. Despite the available literature, robotics for complex advanced NSCLC for re-do surgery remains underexplored. Case presentation We present a 55-year-old female who underwe...

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Main Authors: Ghada Shahin, Rohit Kharbanda, Quirijn Tummers, Jerry Braun
Format: Article
Language:English
Published: BMC 2025-04-01
Series:World Journal of Surgical Oncology
Online Access:https://doi.org/10.1186/s12957-025-03661-0
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author Ghada Shahin
Rohit Kharbanda
Quirijn Tummers
Jerry Braun
author_facet Ghada Shahin
Rohit Kharbanda
Quirijn Tummers
Jerry Braun
author_sort Ghada Shahin
collection DOAJ
description Abstract Background Robot-assisted Thoracic Surgery (RATS) is well-established for complex minimally invasive thoracic surgery. Despite the available literature, robotics for complex advanced NSCLC for re-do surgery remains underexplored. Case presentation We present a 55-year-old female who underwent esophagectomy with gastric pull-up reconstruction for squamous cell carcinoma (SCC) of the esophagus (cT3N2M0, stage IIIB) after neo-adjuvant concurrent chemoradiation therapy (ypT2N1 stage IIB disease). Six years later, computed tomography (CT) scan showed stage IA Thyroid Transcription Factor-1 (TTF-1) positive adenocarcinoma in the left upper lobe treated by stereotactic radiotherapy. Two years later, a SCC of the right upper lobe (RUL) was found (Fig. 1). Although locoregional therapy was preferred Pembrolizumab® was initiated with curative intent as the tumor demonstrated a high Programmed Death-Ligand 1 (PD-L1) expression. Follow-up CT-scan showed no biological response. Salvage lobectomy was proposed, and patient consent obtained. As demonstrated in the video, RATS provided great exposure to the adhesions, vascularization of the neo-oesophagus and maximal dexterity in difficult spaces. Conclusions This case demonstrates the value of RATS in complex re-do thoracic surgery after immunotherapy and previous thoracotomy. Graphical Abstract Robot-Assisted Thoracic Surgery in Re-do Lung Surgery
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spelling doaj-art-256a79d3bcd748288ff4dbb3f2e544b02025-08-20T03:10:14ZengBMCWorld Journal of Surgical Oncology1477-78192025-04-012311410.1186/s12957-025-03661-0Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case reportGhada Shahin0Rohit Kharbanda1Quirijn Tummers2Jerry Braun3Department of Cardiothoracic Surgery, Leiden University Medical Center, Subspecialty Thoracic SurgeryDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Subspecialty Thoracic SurgeryDepartment of Surgery, Antoni Van Leeuwenhoek Hospital, Subspecialty Thoracic SurgeryDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Subspecialty Thoracic SurgeryAbstract Background Robot-assisted Thoracic Surgery (RATS) is well-established for complex minimally invasive thoracic surgery. Despite the available literature, robotics for complex advanced NSCLC for re-do surgery remains underexplored. Case presentation We present a 55-year-old female who underwent esophagectomy with gastric pull-up reconstruction for squamous cell carcinoma (SCC) of the esophagus (cT3N2M0, stage IIIB) after neo-adjuvant concurrent chemoradiation therapy (ypT2N1 stage IIB disease). Six years later, computed tomography (CT) scan showed stage IA Thyroid Transcription Factor-1 (TTF-1) positive adenocarcinoma in the left upper lobe treated by stereotactic radiotherapy. Two years later, a SCC of the right upper lobe (RUL) was found (Fig. 1). Although locoregional therapy was preferred Pembrolizumab® was initiated with curative intent as the tumor demonstrated a high Programmed Death-Ligand 1 (PD-L1) expression. Follow-up CT-scan showed no biological response. Salvage lobectomy was proposed, and patient consent obtained. As demonstrated in the video, RATS provided great exposure to the adhesions, vascularization of the neo-oesophagus and maximal dexterity in difficult spaces. Conclusions This case demonstrates the value of RATS in complex re-do thoracic surgery after immunotherapy and previous thoracotomy. Graphical Abstract Robot-Assisted Thoracic Surgery in Re-do Lung Surgeryhttps://doi.org/10.1186/s12957-025-03661-0
spellingShingle Ghada Shahin
Rohit Kharbanda
Quirijn Tummers
Jerry Braun
Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report
World Journal of Surgical Oncology
title Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report
title_full Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report
title_fullStr Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report
title_full_unstemmed Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report
title_short Re-do robot-assisted salvage lobectomy after esophagectomy with gastric pull-up reconstruction: a case report
title_sort re do robot assisted salvage lobectomy after esophagectomy with gastric pull up reconstruction a case report
url https://doi.org/10.1186/s12957-025-03661-0
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AT quirijntummers redorobotassistedsalvagelobectomyafteresophagectomywithgastricpullupreconstructionacasereport
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