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Updated: Jun 4, 2026
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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
Published on: April 19, 2024
Uniportal & biportal robotic anatomic lung resection (without CO2 insufflation): technique, initial experience and
Gregor J Kocher1,2,3, Svea Wegener3, Sarah Deckarm2,3
1Department of Thoracic Surgery, St. Claraspital Basel, Basel, Switzerland.
Journal of Visualized Surgery
|June 3, 2026
Summary
Robotic-assisted thoracic surgery (RATS) using uniportal (uRATS) or biportal (bRATS) approaches for anatomic lung resection demonstrates safety and feasibility. Both methods show comparable perioperative outcomes, though RATS is currently more costly than video-assisted thoracic surgery (VATS).
Area of Science:
- Thoracic Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robotic-assisted thoracic surgery (RATS) has evolved from multiportal to uniportal techniques for lung resections.
- Technological advancements enable uniportal RATS (uRATS) without carbon dioxide insufflation, enhancing safety and feasibility.
Purpose of the Study:
- To evaluate the safety and feasibility of uniportal (uRATS) versus biportal (bRATS) robotic-assisted anatomic lung resections.
- To compare perioperative outcomes, including blood loss, operation duration, lymph node yield, complications, and length of stay.
Main Methods:
- Retrospective analysis of 13 patients undergoing uRATS or bRATS for anatomic lung resection using the da Vinci Xi platform.
- Data collected included surgical approach, procedure details, perioperative outcomes, and costs.
Main Results:
- No intraoperative complications or conversions to VATS/thoracotomy were observed in either uRATS or bRATS.
- Perioperative blood loss, operation duration, lymph node yield, chest tube duration, and length of hospital stay were comparable between uRATS and bRATS.
- Robotic surgery was found to be costlier than conventional uniportal VATS.
Conclusions:
- Uniportal and biportal RATS for anatomic lung resection are safe and feasible with good perioperative results.
- RATS facilitates thorough lymphadenectomy due to enhanced ergonomics and maneuverability.
- While RATS offers benefits, current robotic platforms lead to higher overall costs compared to VATS.
