Robotic Lobectomy with a Single Robotic Stapler from One 12-mm Port: A Multi-institutional Study

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.