Robot-assisted lung resection: outcomes and technical details

Robotic surgery has gained acceptance for surgical use but few data exist regarding its value in thoracic procedures. The aim of this study is to report our experience with totally robotic thoracic resections. From June 2001 to June 2009, 38 consecutive totally robotic lung resections were performed in two different hospitals by a single surgeon. All data was prospectively collected in a dedicated database, and reviewed retrospectively. A total of 32 lobectomies, three bilobectomies, and three pneumonectomies were performed. The indication was a malignant tumor in 28 cases. There were nine cases with benign pathology. Mean operating time was 209 min (range: 105-380 min). Six conversions were required (15.8%) and there was one postoperative death (2.6%). Four postoperative complications occurred (10.5%). Median hospital stay was 10 days (range: 3-24 days). After a median follow-up of 42 months, 80% of patients with stage I disease are alive without recurrence. Advanced thoracic procedures can be performed safely using the robotic system. In this heterogeneous series of lung resections, we report low mortality and morbidity. The robotic approach can achieve a good dissection in difficult to reach areas, making it particularly useful for oncologic resections.