Initial Experience of Single-Port Robotic Lobectomy for Large-Sized Non-Small Cell Lung Cancer: A Single-Center...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Single-port robotic-assisted thoracic surgery (SP-RATS) offers potential benefits but faces challenges like collisions and a steep learning curve.
• Widespread adoption of SP-RATS is limited, particularly for complex cases such as large non-small cell lung cancer (NSCLC).

Purpose of the Study:

• To evaluate the feasibility and safety of SP-RATS lobectomy for large-sized NSCLC (greater than 5 cm).
• To assess the efficacy of a modified SP-RATS approach with a slightly larger incision (6-8 cm) for large tumors.

Main Methods:

• Retrospective analysis of 11 patients who underwent SP-RATS lobectomy for large NSCLC using the da Vinci Xi system.
• Inclusion criteria: NSCLC tumors > 5 cm, treated between April 2022 and May 2024.
• Data collected included operative time, tumor size, postoperative length of stay, and complications (Clavien-Dindo classification).

Main Results:

• Median tumor size was 6.6 cm (CT) and 6 cm (pathology).
• Median operative time was 198 minutes; median postoperative stay was 4 days.
• No major postoperative complications (≥grade III) were observed.

Conclusions:

• SP-RATS lobectomy is a safe and feasible approach for large-sized NSCLC.
• This technique may combine the advantages of single-port and robotic surgery, potentially improving outcomes for patients with large tumors.