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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
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Robotic Lobectomy with a Single Robotic Stapler from One 12-mm Port: A Multi-institutional Study.

Yoshimasa Inoue1, Koichi Fujiu2, Tetsuya Endo3

  • 1Department of General Thoracic Surgery, Saiseikai Yokohama-shi Tobu Hospital, Yokohama, Japan.

The Keio Journal of Medicine
|July 28, 2024
PubMed
Summary
This summary is machine-generated.

Robotic lobectomy using a single type of stapler through one 12-mm port is feasible. This approach simplifies procedures, potentially reduces postoperative pain, and lowers inventory costs for robotic surgery.

Keywords:
costpostoperative painrobotic lung resectionrobotic stapler

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Robotic lobectomy offers autonomy but uses larger 12-mm ports, increasing postoperative pain risk.
  • Using two 12-mm ports is common for optimal surgical angles, yet increases instrument inventory and complexity.
  • Simplifying procedures and reducing costs are key goals in robotic surgery.

Purpose of the Study:

  • To assess the feasibility of robotic lobectomy using a single type of stapler (SureForm45 Curved-Tip) via one 12-mm port.
  • To investigate the cost-effectiveness of using an additional 60-mm stapler for interlobar division compared to the single stapler approach.

Main Methods:

  • A multicenter study involving 135 robotic lobectomy cases.
  • Utilized a single type of robotic stapler, SureForm45 Curved-Tip (SF45C), inserted through a single 12-mm port.
  • Analyzed stapling procedures and compared costs associated with using additional staplers for interlobar division.

Main Results:

  • All stapling procedures were successfully completed using the SF45C from the single 12-mm port in all 135 cases.
  • Using an additional 60-mm stapler was potentially cost-effective only if more than six SF45C reloads were needed for interlobar division.
  • This specific cost-saving scenario occurred in only one case (0.7%).

Conclusions:

  • Robotic lobectomy with a single type of stapler inserted via one 12-mm port is technically feasible.
  • This approach can simplify surgical procedures and potentially minimize postoperative pain.
  • Reduced instrument inventory and associated costs are potential benefits of this streamlined technique.