Related Experiment Video
Updated: May 13, 2025
Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
Published on: April 19, 2024
Implementation of a robotic-assisted thoracic surgery program for anatomical lung resections, a single surgeon's
Andreas Westerlind1,2, Maya Landenhed-Smith1,2, Carl-Johan Malm1,2
1Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background:
Robotic-assisted thoracic surgery (RATS) for pulmonary resections has been reported to be a safe and feasible method with similar outcomes to those of video-assisted thoracic surgery (VATS). In 2021 our department launched a RATS program. The aims of this study are to evaluate the initial results and learning curve of a series of RATS procedures performed by a single surgeon experienced in uniportal video-assisted thoracic surgery (uVATS) during an initial period of access to the robotic platform limited to two cases per week.
Methods:
A retrospective study including consecutive RATS and uVATS lobectomies performed by a single surgeon from November 2021 to September 2023 at Sahlgrenska University Hospital. Endpoints were days with chest tube (CT), length of stay (LOS) and intraoperative learning curve as reflected in the duration of procedures.
Results:
A total of 82 RATS and 60 uVATS consecutive lobectomies were included. Preoperative demographics were similar in the RATS and uVATS groups. Preoperative assessment of tumour size from computed tomography scans were larger in the uVATS group than in the RATS group [25 (18.00-39.00) vs. 18 (14.00-28.25) mm, P=0.002], but clinical tumour-node-metastasis (TNM) stage were similar between groups (P=0.23). Days with CT was significantly shorter for RATS than uVATS [1.00 (1.00-1.00) vs. 1.00 (1.00-3.75)]; P=0.01]. LOS in the RATS group was 2 [2.00-3.00] vs. 2 [2.00-5.00] days in the uVATS group (P=0.07). Operation time (OP time) was longer in the RATS group [136.00 (114.50-152.25) vs. 100 (84.25-120.00) minutes in the uVATS group; P<0.001]. After RATS case number 44 no further reduction in OP time was recorded.
Conclusions:
RATS is a feasible method for lobectomy and can be efficiently introduced as a standard surgical approach even with limited access to the robotic surgical platform, with a learning curve of approximately 44 cases.
