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Completely portal robotic lobectomy (CPRL) is a safe and reproducible minimally invasive technique for pulmonary lobectomy. CPRL outcomes are comparable to VATS and superior to open surgery, showing broad applicability in community settings.

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Video-assisted thoracoscopic surgery (VATS) offers advantages over open thoracotomy for pulmonary lobectomy but faces adoption challenges in community settings.
  • Completely portal robotic lobectomy (CPRL) is emerging as a potential solution to these limitations.
  • This multicenter study assesses the initial experience of 6 community cardiothoracic surgeons with CPRL.

Purpose of the Study:

  • To evaluate the safety, reproducibility, and outcomes of early Completely Portal Robotic Lobectomy (CPRL) in community cardiothoracic surgery practices.
  • To compare CPRL outcomes with Video-Assisted Thoracoscopic Surgery (VATS) and open thoracotomy.
  • To determine the applicability of CPRL across varied practice settings.

Main Methods:

  • Retrospective analysis of 120 consecutive, unselected CPRL cases from 6 community surgeons.
  • Comparison of CPRL data with Society of Thoracic Surgeons database records for VATS (n=4,612) and open lobectomy (n=5,913).
  • Statistical analysis using chi-squared and t-tests with significance defined at p < 0.05.

Main Results:

  • 96.7% of lobectomies were completed robotically with a low 3.3% conversion rate.
  • CPRL demonstrated equivalence to VATS in intraoperative and postoperative outcomes.
  • CPRL showed significantly lower rates of postoperative blood transfusion, prolonged air leaks, shorter chest tube duration, and reduced length of stay compared to open surgery.

Conclusions:

  • Early experience indicates CPRL is a safe and reproducible minimally invasive lobectomy technique suitable for diverse practice settings.
  • CPRL outcomes are comparable to VATS, with favorable trends favoring robotic approaches.
  • CPRL offers superior results compared to open surgery, suggesting broad applicability due to minimal patient selection and low conversion rates.