EARLY EXPERENCE WITH UNIPORTAL ROBOTIC THORACIC SURGERY LOBECTOMY

This is the accepted manuscript of the paper "EARLY EXPERENCE WITH UNIPORTAL ROBOTIC THORACIC SURGERY LOBECTOMY" that will be published in Frontiers in Surgery (acceptation number  1005860).

Abstract

Background. Invasiveness is considered one of the cornerstones in every field of surgery and Video-assisted thoracoscopic (VATS) approaches are now routinely used worldwide to perform pulmonary resections. Recently, robotic-assisted thoracic surgery (RATS) is becoming the preferred technique in many centers but it is routinely performed using 3 or 4 ports with at least one service incision, being in contrast with the real concept of invasiveness, especially if compared to uniportal VATS (U-VATS). Hereby we present our early experience with uniportal RATS (U-RATS) pulmonary resections for early-stage lung cancer. Technical details of surgical steps are accurately described and commented.

Results. Twenty four consecutive patients with lung cancer underwent U-RATS anatomical pulmonary resections at our Institute. All procedures were completed with uniportal approach. Mean operative time was 210 minutes (range 120-350); in the last 10 cases the operative time was significantly reduced (180 minutes) compared to the first 10 cases (232 minutes) (p< 0.02), showing a very fast learning curve.  Post-operative pain score was comparable to U-VATS and was constantly low.

Conclusions. U-RATS is a safe and feasible technique, combining the advantages of U-VATS to the well-known advantages of robotic surgery.