Uniportal robotic thoracic surgery - an early Indian experience

Thoracic surgery has been conventionally performed via thoracotomy over many years. However, over the past few decades, lung surgery has evolved from open to minimally invasive surgery. Our robotic thoracic surgery programme started in October 2022. Since we were already performing uniportal video-assisted thoracic surgery (Uniportal VATS), we found it difficult to get oriented to the multi-port approach. So we decided to perform uniportal robot-assisted thoracic surgery (URATS). This article represents our initial experience in URATS.

We analysed the data of people who underwent URATS at our hospital. Twenty-one patients were included in this study. This was a retrospective study. Out of the 21 patients, 14 patients underwent surgery for benign conditions and 7 patients underwent surgery for malignancy. Thirteen patients underwent lobectomy, 1 patient underwent segmentectomy, 3 patients underwent wedge resection, 3 patients underwent mediastinal mass excision, and 1 patient underwent bronchogenic cyst excision. Out of the lobectomy group, 6 patients had benign conditions, the other 6 being operated for malignancy. All surgeries were performed by a single console surgeon using the da Vinci Xi robotic platform and the same assistant at the bedside.

There was no conversion to a multiport robotic thoracic surgery or thoracotomy in our series. The average console time for the entire study group was 177.9 min. The average instrument active time for the entire study group was 130.5 min. The median instrument count per case in our study was 4. The average console time for lobectomy was 231.53 min. The average instrument active time for lobectomy was 174 min.

We conclude that, in appropriate patients, Uniportal RATS can be a safe and feasible alternative to other minimally invasive techniques in both benign and malignant conditions.

The online version contains supplementary material available at 10.1007/s12055-024-01862-y.