Experience with robotic lobectomy for lung cancer

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Robotic-assisted surgery is increasingly adopted for pulmonary lobectomy.
• Establishing a learning curve is crucial for optimizing surgical outcomes and patient safety.

Purpose of the Study:

• To analyze the institutional experience with robotic pulmonary lobectomy.
• To compare outcomes with existing literature.
• To propose a learning curve for robotic lobectomy.

Main Methods:

• Ninety-one patients with clinical stage I-III lung cancer underwent robotic lobectomy using the da Vinci system.
• Operations were performed by a single surgeon using a three-port technique with a small utility incision.
• Exclusion criteria included lesions larger than 5 cm and compromised respiratory function.

Main Results:

• Operative time decreased significantly from the initial 18 cases to the subsequent 73 cases (260 vs. 221 minutes, P=0.01).
• Postoperative hospitalization was reduced (6 vs. 5 days, P=0.002), with a trend towards fewer complications and major complications (11% vs. 4%).
• No 30-day mortality was observed, and 80 of 91 patients remained disease-free at 24 months median follow-up.

Conclusions:

• Surgical competence in robotic pulmonary lobectomy is estimated to require around 20 cases.
• Robotic lobectomy demonstrates safety and oncological efficacy.
• The procedure offers a shorter postoperative hospitalization period compared to traditional open surgery.