Robotic thyroidectomy has been developed to minimize neck scarring, and several authors have described its feasibility and safety, and have reported surgical outcomes comparable with conventional open thyroidectomy. The da Vinci surgical system robot provides a three-dimensional $10-12{\times}$magnified view of the surgical area. It also provides hand-tremor filtration, fine motion scaling, and precise and multi-articulated hand-like motions. Recently, robotic technology has also been applied to lateral compartment neck dissection in thyroid cancer. We have developed a new novel selective neck dissection procedure by a gasless unilateral axillo-breast (GUAB) approach with a da Vinci Surgical System for well-differentiated thyroid carcinoma to avoid a long visible neck scar. Based on our early experience, robotic selective neck dissection by GUAB approach is a safe, feasible and cosmetically excellent procedure. It can be an alternative to conventional open surgery in the highly selected patients with well-differentiated thyroid carcinoma. The oncologic safety of robotic selective neck dissection should be verified with long-term follow-up data.

Robotic surgery have been increasingly applied in the past several years to assist in a variety of operations. Some applications, such as in prostatectomy, have been widely adopted and have largely supplanted the alternative minimally invasive or open techniques. However, the use of surgical robots in esophagectomy has not been as common. Although a limited number of case reports demonstrated the feasibility of robotic esophagectomy, no large series of patients has been reported to date. The data on robotic-assisted esophagectomy suggest that the procedure is safe, feasible, and associated with perioperative outcomes similar to open and minimally invasive esophagectomy. Benefits of robotic system could be maximized when we do a extensive total mediastinal lymphadenectomy. For this procedure to gain widespread acceptance, identifiable benefit relative should be demonstrated in near future.

MMinimally invasive surgery (MIS) for early stage lung cancer has been an important treatment modality. However, the ergonomic discomfort and counterintuitive instruments hindered the application of video-assisted thoracic surgery (VATS) to more advanced procedures. To improve the compliance with MIS, robotic surgery was adopted. This advance aimed to alleviate the shortcomings of VATS by maximizing the comfort of the surgeon while providing instruments that enabled technically demanding operations and three-dimensional views with increased freedom for intrathoracic movement owing to EndoWrist$^{(R)}$. In this session, we introduced the clinical applications and its results of robot-assisted thoracic surgery in the field of lung cancer surgery. In conclusion, robot-assisted pulmonary resection with lymph node dissection for lung cancer is safe as well as feasible, and it results in a satisfying postoperative outcome. Robot-assisted surgery may provide a good alternative to conventional open or thoracoscopic surgery for lung cancer, provided that the cost effectiveness and long-term prognosis are confirmed.

Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.

Background and Objectives Scope classification is designed to classify acute epiglottitis according to laryngoscopic findings. There is no report about the utility of classification; the difference between the diagnosis and the prognosis by the Scope classification was not found. The aim of this study was to evaluate the utility of Scope classification in patients with acute epiglottitis. Subject and Method 127 patients who had been admitted to our hospital were diagnosed with acute epiglottitis. The patients were classified by the Scope classification. We compared demographic characteristics, clinical symptoms and signs, laboratory findings, and clinical course among the patient groups and divided the results according to the Scope classification. Results There are no significant differences among the groups in demographic characteristics, clinical symptoms and signs, laboratory findings, and clinical course. Conclusion The Scope classification of acute epiglottitis does not seem to be a method to evaluate the severity of acute epiglottitis. Thus, we need to develop multidisciplinary approaches for acute epiglottitis.

Epiglottic cysts cause stridor mimicking asthma and hinder intubation in surgery. A huge cyst can obstruct the airway, making laryngeal examinations impossible. Before surgery, complete visualization of the larynx is necessary for the successful excision of a cyst. If laryngeal examination fails, computed tomography (CT) scanning can provide detailed information. Virtual endoscopy based on CT data reconstruction can yield a detailed three-dimensional image of the larynx. Here, we report two cases of epiglottic cysts along with virtual endoscopic findings and surgical photographs.

Several reports have investigated airway obstruction caused by redundancy of arytenoid mucosa. Flexible laryngoscope examination revealed prolapse of the mucosa overlying the arytenoid. Usually, pharyngeal or laryngeal microscopic procedures can successfully treat the redundancy of arytenoid mucosa. We experienced two cases of airway obstruction caused by redundancy of artenoid mucosa and report it with review of literatures.

Computed tomography with virtual bronchoscopy shows inner shape of trachea and major bronchi with three-dimensional images. Virtual bronchoscopy can be used in cases of suspected foreign body aspiration. Virtual bronchoscopy shows the exact location of the obstructive lesion before conventional bronchoscopy. If the chest radiography is normal or suggests aspirated foreign body, virtual bronchoscopy can be considered before conventional bronchoscopy. We experienced a case of false-tooth foreign body extracted under bronchoscopy. In this case, virtual bronchoscopy was made retrospectively giving useful information about shape and orientation regarding foreign body.

A bronchogenic cyst is an uncommon benign congenital anomaly of the primitive ventral forgut which was generally encountered within the mediastinum and detected in pediatric patients. It is rarely detected in adult population as a lateral neck mass. We have recently experienced one case of bronchogenic cyst as a left lateral neck mass in a 49-year-old male. He complaints of a $2{\times}1$ cm sized, soft, non tender, and movable mass on the low lateral neck. The surgical excision of mass was performed and the final histopathologic diagnosis was a bronchogenic cyst. Here, we report this case with the review of literatures.