{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:31:06Z","timestamp":1791995466668,"version":"4.4.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Troubleshooting intraoperative complications requires careful management, and the safest technique should be chosen. We recently experienced a unique intraoperative bronchial complication during pulmonary lobectomy in robot-assisted thoracic surgery (RATS). There is no consensus on whether to continue RATS or convert to a more familiar technique, such as video-assisted thoracic surgery (VATS) or thoracotomy, for intraoperative complications that occur during RATS, and the decision should be determined individually.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 74-year-old woman with primary lung adenocarcinoma (clinical stage IA2) underwent robot-assisted right lower lobectomy under one-lung ventilation and CO<jats:sub>2<\/jats:sub> insufflation. Intraoperatively, the anesthesiologist placed the endobronchial suction tube in the right bronchus with intention of maintaining the right lung collapse, which was simultaneously stapled with the right lower bronchus during the right lower lobe bronchial closure using a robotic stapler. During robot-assisted manipulation, we removed the staples involved with the suction tube, one by one, using robotic-arm forceps and sutured the partially opened stump. Subsequently, the bronchial stump was covered with a pedicled pericardial fat pad. The postoperative course was uneventful, and the patient developed no complications when followed up 8 months after discharge. Hence, we could rectify this intraoperative bronchial complication using a robot-assisted technique and avoid conversion to VATS or thoracotomy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The precise manipulation techniques in RATS contributed to facilitate the successful execution of surgical procedures, such as staple removal and re-suturing of the bronchial stump and may be a useful as a method for such troubleshooting such intraoperative complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-021-01278-5","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T09:21:55Z","timestamp":1629710515000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stapling of an endobronchial suction tube with the bronchus during robot-assisted right lower lobectomy: a case report"],"prefix":"10.1186","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2288-9229","authenticated-orcid":false,"given":"Hiroto","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruhiro","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Oda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimasa","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"key":"1278_CR1","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1016\/S1010-7940(02)00102-1","volume":"21","author":"FM Melfi","year":"2002","unstructured":"Melfi FM, Menconi GF, Mariani AM, Angeletti CA. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg. 2002;21:864\u20138.","journal-title":"Eur J Cardiothorac Surg"},{"key":"1278_CR2","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1016\/j.jtcvs.2011.07.022","volume":"142","author":"RJ Cerfolio","year":"2011","unstructured":"Cerfolio RJ, Bryant AS, Skylizard L, Minnich DJ. Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg. 2011;142:740\u20136.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"1278_CR3","first-page":"3","volume":"1","author":"C Cao","year":"2012","unstructured":"Cao C, Manganas C, Ang SC, Yan TD. A systematic review and meta-analysis on pulmonary resections by robotic video-assisted thoracic surgery. 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Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg. 2011;23:36\u201342.","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"1278_CR7","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1053\/j.jvca.2005.04.011","volume":"20","author":"RG Soto","year":"2006","unstructured":"Soto RG, Oleszak SP. Resection of the Arndt bronchial blocker during stapler resection of the left lower lobe. J Cardiothorac Vasc Aneth. 2006;20:131\u20132.","journal-title":"J Cardiothorac Vasc Aneth"},{"key":"1278_CR8","doi-asserted-by":"publisher","first-page":"287","DOI":"10.4097\/kjae.2015.68.3.287","volume":"68","author":"YH Lee","year":"2015","unstructured":"Lee YH, Yang HM, Kim HC, Bahk JH, Seo JH. Transection of a Coopdech bronchial blocker tip during bronchial resection for right upper lobectomy: a case report. Korean J Anesthesiol. 2015;68:287\u201391.","journal-title":"Korean J Anesthesiol"},{"key":"1278_CR9","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1016\/j.jtcvs.2011.09.028","volume":"142","author":"RM Flores","year":"2011","unstructured":"Flores RM, Ihekweazu U, Dycoco J, Rizk NP, Rusch VW, Bains MS, et al. Video-assisted thoracoscopic surgery (VATS) lobectomy: catastrophic intraoperative complications. J Thorac Cardiovasc Surg. 2011;142:1412\u20137.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"1278_CR10","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1093\/ejcts\/ezv287","volume":"48","author":"H Decaluwe","year":"2015","unstructured":"Decaluwe H, Petersen RH, Hansen H, Piwkowski C, Augustin F, Brunelli A, et al. Major intraoperative complications during video-assisted thoracoscopic anatomical lung resections: an intension-to-treat analysis. Eur J Cardiothorac Surg. 2015;48:588\u201398; discussion 599.","journal-title":"Eur J Cardiothorac Surg"},{"key":"1278_CR11","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1016\/j.athoracsur.2019.05.020","volume":"108","author":"C Cao","year":"2019","unstructured":"Cao C, Cerfolio RJ, Louie BE, Melfi F, Veronesi G, Razzak R, et al. Incidence, management, and outcomes of intraoperative catastrophes during robotic pulmonary resection. Ann Thorac Surg. 2019;108:1498\u2013504.","journal-title":"Ann Thorac Surg"},{"key":"1278_CR12","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s11748-020-01419-x","volume":"69","author":"H Ueno","year":"2021","unstructured":"Ueno H, Watanabe Y, Hirayama S, Hattori A, Imashimizu K, Takamochi K, et al. Intraoperative complications and troubles in robot-assisted anatomical pulmonary resection. 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