Robotic Right Upper Sleeve Resection and Azygus Flap

Robotic right upper sleeve lobectomy is an advanced minimally invasive thoracic procedure performed for centrally located right upper lobe tumors involving the bronchus, allowing oncologic resection while preserving lung parenchyma. Using the robotic platform, precise dissection of the pulmonary vessels and bronchus is achieved with enhanced three-dimensional visualization and superior instrument articulation, facilitating meticulous bronchial resection and end-to-end bronchial anastomosis. After completion of the sleeve reconstruction, an azygos vein flap can be harvested and mobilized as a well-vascularized pedicled tissue to buttress and protect the bronchial anastomosis. The azygos flap provides additional vascular support, reduces tension at the suture line, and may decrease the risk of bronchopleural fistula or anastomotic complications. The combination of robotic sleeve lobectomy with azygos flap reinforcement exemplifies the benefits of robotic thoracic surgery in managing complex airway resections with precision, safety, and favorable postoperative outcomes.