[Robot-assisted Segmentectomy for Lung Cancer].

摘要

The role of segmentectomy for lung cancer is expected to increase owing to the results of Japan Clinical Oncology Group (JCOG) 0802. Moreover, the major advantage of robot-assisted thoracic surgery (RATS) is that it allows high precision of dissection. The surgical approach comprised the placement of four robotic ports on the lower intercostal space with an assistant hole. While performing robotic surgery without haptic sensation, it is considered safe to dissect the bronchus first followed by the interlobar and intersegmental plane dissection at the end. In our institution, 52 lung cancer segmentectomies were performed between April 2020 and April 2022, out of which 8 (15.4%)were robot-assisted. The median operating time and console time for RATS were 233 and 182 minutes, respectively, showing a trend towards significantly longer operating time as compared to thoracoscopic segmentectomy( 184 vs. 233 minutes, p=0.007). There were no significant differences in the time to drain removal, the incidence of complications, or pain scores at discharge. Although robotic surgery provides the surgeon with better view and greater precision, it does not decrease the operation time and pain. However, robot-assisted surgery is expected to deliver greater benefits to the patient with technological advances in devices and surgical techniques.