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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
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Contralateral Robotic-Assisted Anatomical Resection for Synchronous or Metachronous Lung Cancer: A Retrospective Case

Alessio Campisi1,2, Nabil Khan2,3, Federica Pinna2,3

  • 1Thoracic Surgery, Department of Surgery, P. Pederzoli Hospital, Peschiera Del Garda, 37019 Verona, Italy.

Journal of Clinical Medicine
|August 28, 2025
PubMed
Summary

Robotic-assisted thoracic surgery offers a safe and feasible option for contralateral anatomical lung resections in non-small cell lung cancer (NSCLC) patients. This minimally invasive approach demonstrates good perioperative outcomes without mortality, even in complex cases.

Keywords:
NSCLCcontralateral lung resectionlobectomyrobotic-assisted thoracic surgerysegmentectomy

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Increased detection of early-stage non-small cell lung cancer (NSCLC) leads to more patients needing contralateral anatomical lung resections.
  • Contralateral resections pose surgical challenges due to potential lung function impairment and one-lung ventilation complexities.
  • Robotic-assisted thoracic surgery (RATS) is explored as a solution for these complex cases.

Purpose of the Study:

  • To evaluate the feasibility and safety of RATS for contralateral anatomical lung resections in NSCLC patients.
  • To assess perioperative and oncological outcomes of RATS in this patient cohort.

Main Methods:

  • Retrospective analysis of 20 patients undergoing RATS contralateral anatomical resection (January 2019 - June 2024).
  • Assessment of preoperative pulmonary function, perioperative characteristics, and oncological outcomes.
  • Recording of operative parameters: conversion rates, intraoperative oxygenation, ECMO use, and postoperative complications.

Main Results:

  • Seventy percent of resections were for metachronous tumors; median FEV1 was 75.94%.
  • Segmentectomy was the most common procedure (65.0%); median operative time was 148.0 min.
  • No conversions to open surgery or ECMO needed; complications in 25% (mostly Clavien-Dindo grade 2); no mortality observed.

Conclusions:

  • RATS contralateral anatomical lung resection is a feasible and safe approach for NSCLC patients with prior contralateral surgery.
  • RATS provides a minimally invasive alternative for complex thoracic surgical cases.
  • The study supports RATS as a viable option for managing contralateral lung resections.