Background: Robot-assisted thoracic surgery offers significant advantages, with the surgeon operating from a console via 3 D Visulisation instead of standing at the operating table. However, this setup necessitates thorough preparation to handle bleeding emergencies, as the console surgeon may require time to reach the operating table. Although the incidence of massive intraoperative bleeding during robotic thoracic surgery is generally low [1], the potential consequences can be catastrophic if not managed optimally. This study aims to analyze bleeding events occurring during robotic lobectomies at our center and present our therapeutic approach in cases of significant bleeding. Method: This retrospective study focuses on a single center and spans from October 2018 to July 2023, involving 220 patients who underwent robotic lobectomy for lung cancer. Among them, intraoperative bleeding occurred in seven cases. These events were carefully analyzed, and appropriate steps for management were undertaken. We excluded robot-assisted wedge resections from the study, as well as any conversions to thoracotomy that occurred for reasons other than intraoperative catastrophic bleeding, such as those related to oncological or technical considerations. Patient baseline characteristics, including gender, age, BMI (body mass index), and respiratory function, were collected and analyzed. Operative time, from the time of skin incision to the time of skin closure, including docking of the robotic system, was recorded. Additionally, the type of procedure, histology, tumor localization, and pathological results were carefully documented and analyzed. We defined catastrophic intraoperative bleeding events as bleeding events that demand emergency management due to their life-threatening nature. In these scenarios, we considered both the continuation of robotic surgery and the option of performing a thoracotomy as potential approaches [2]. Data collection and management were conducted seamlessly through a prospective database. The study employed observational analysis, and data were described using absolute and relative (%) frequency for categorical data, and mean and range for continuous data. Results: Between October 2018 and July 2023, 220 robotic lobectomies were performed. Among them, significant intraoperative vascular injury occurred in seven patients, leading to a conversion to thoracotomy in three cases. In four Cases, we were able to manage the bleeding robotically. The left side of the lung was affected in four cases (3 Upper and 1 Lower lobe) and therefore the left side was more frequently. The other three cases were two right Upper lobe and one middle lobeinjury. Patients with intraoperative bleeding experienced a longer total operative time than those without such complications. Two patients with massiv bleeding (2/7; 42,8%) required packed red blood cell transfusions. Conclusion: Intraoperative catastrophic bleeding events are unpredictable occurrences that can even happen to experienced surgical teams. Given the widesprea...