Uniportal fully robotic-assisted major pulmonary resections

Area of Science:

• Minimally Invasive Thoracic Surgery
• Robotic Surgery Advancements
• Surgical Oncology

Background:

• Robotic-assisted thoracoscopic surgery (RATS) offers superior visualization and dexterity compared to conventional methods.
• Traditional RATS often requires multiple incisions, limiting its minimally invasive benefits.
• Uniportal video-assisted thoracoscopic surgery (UVATS) has evolved, paving the way for single-port robotic techniques.

Discussion:

• The Da Vinci Xi platform's arm configuration facilitates adaptation to a uniportal approach.
• Initial feasibility studies using Da Vinci Si and X platforms demonstrated potential for URATS.
• The development of specialized instruments and high-definition cameras has been crucial for complex uniportal procedures.

Key Insights:

• The Da Vinci Xi system enables a reduction in incisions for RATS, ultimately achieving a single-incision approach (URATS).
• Pure or fully robotic URATS involves performing thoracic surgery through a single intercostal incision without rib spreading.
• The first fully robotic anatomic resections using the URATS approach were successfully performed in September 2021.

Outlook:

• Routine adoption of the URATS approach is anticipated with the optimized Da Vinci Xi platform.
• Further advancements in robotic technology may enhance the capabilities and applications of single-port thoracic surgery.
• This technique holds promise for improving patient recovery and reducing surgical trauma in thoracic procedures.