Early Experience With Robotic Lung Resection Results in Similar Operative Outcomes and Morbidity When Compared With Matched Video-Assisted Thoracoscopic Surgery Cases

Robotic Surgery for Thoracic Disease

“…5,22) Furthermore, other groups reported similar morbidity and mortality rates between robotic and VATS lobectomy. 9,17,23) However, they showed shorter hospital stays after robotic lobectomy than open lobectomy. Pardolesi et al reported the safety and feasibility of robotic segmentectomy, including a 17.6% morbidity rate.…”

“…5,22) Other groups compared removed lymph nodes in robotic surgery with VATS lobectomy and found no differences between the two procedures. 9,17) On the other hand, since the frequency of upstaging in clinically node negative lung cancer is a surrogate marker for completeness of lymph nodes dissection, Park et al reported the upstaging rate in robotic surgery. 6) They found 13% of N1 upstaging in stage I cases, with similar radicality to open surgery reported by Boffa et al Another group reported 6.6% of N1 and 4.3% in N2 upstaging by robotic major anatomical resection for lung cancer.…”

“…The other groups also reported a three-arm technique with one utility port. 9,[15][16][17] Cerfolio et al reported a four-arm technique without a utility incision, while Veronesi et al included the incision. 5,8) Carbon dioxide (CO 2 ) insufflation to achieve maximal surgical exposure while compressing the lung away from the operative area may provide the benefit for thoracoscopic surgery.…”

Feasibility of four-arm robotic lobectomy as solo surgery in patients with clinical stage I lung cancer

“…The previous settings for conventional robotic lobectomy usually require an experienced bedside surgeon for retraction of the lung, suctioning of retained blood, and stapling. For example, in Louie's report, the first 30 pulmonary resections used 2 attending surgeons (one on the console and one at the bedside); after 30 cases, a thoracic surgery fellow was used as the bedside assistant (9). The need for two surgeons in one robotic operation is excessive use of medical personnel.…”

“…Based on these advantages, robotic surgery has been introduced in certain fields of thoracic surgery such as mediastinal tumor excision, esophageal cancer, and lung cancer (7)(8)(9)(10). As robotics can provide three-dimensional visualization and greater instrument maneuverability in a confined space, it has the potential of enhancing minimally invasive thoracoscopic lobectomy (11).…”