[Uniportal Robotic Assisted Pulmonary Resection]

We introduced the uniportal robotic assisted thoracic surgery (URATS) using da Vinci Xi in 2023 after notification to and approval by the Highly Difficult and New Medical Technology Review Division of the Osaka University Hospital. In our department, URATS is indicated for c-stage 1 lung cancer, metastatic lung tumors, and benign diseases.

The cross-shaped center guide point is aligned with the dorsal surface of the window. The most dorsal arm is not used, and the camera is placed on the dorsal side. The assistant checks which arm is interfering and adjusts the position and height of the port to find a point where there is no interference. It is also important to select a field of view that allows safe manipulation of the target structure without interference, rather than sticking to one field of view.

One of the advantages of the URATS is that it allows for a close view. While this allows for highly accurate surgery, it also has disadvantages in terms of cost and learning curve. We plan to continue to accumulate and validate cases, as this may be a beneficial treatment option for patients.