Minimally invasive management of pulmonary artery bleed in robotic left upper lobectomy

While robotic-assisted thoracoscopic surgery offers some advantages over open surgery, the minimally invasive management of intraoperative bleeding has some limitations, which can necessitate open conversion. We present a case of minimally invasive management of a pulmonary artery bleed in a patient who underwent a robotic left upper lobectomy for a Pancoast tumour. An additional working port was created to allow placement of a vascular clamp for proximal control of the pulmonary artery, thereby improving visualization and primary suture repair. With appropriate experienced surgical assistance and temporary control of bleeding with compression, successful robotic management can be achieved. This case demonstrates that minimally invasive techniques can be used to control intraoperative bleeding and avoid conversion to an open procedure while maintaining patient safety.