Single-Port Robotic-Assisted Approach in Thoracic Surgery: A Prospective Real-World Study

摘要

OBJECTIVE: Robotic systems have enhanced thoracic surgery through 3D visualization, manoeuvrability, and tremor filtration. This study evaluated the effectiveness and safety of the da Vinci single-port surgical system for thoracic surgery in a Chinese population (ClinicalTrials.gov; NCT06246617). DESIGN: Patients with highly malignant pulmonary nodules suitable for minimally invasive lung resection underwent anatomical lung resection using a single-port robotic system between December 2023 and May 2024. Perioperative and short-term follow-up outcomes were also assessed. Clinical data from another clinical trial (RVlob Trial: NCT03134534) were also obtained for comparison. RESULTS: The procedure was successful in all 15 patients without intraoperative conversion, although 3 required an additional auxiliary port owing to a high body mass index and complex anatomy. Additionally, the median intraoperative blood loss and operative time were 15 (interquartile range [IQR], 10-37.5) mL and 100 (IQR, 86-119) minutes, respectively. The median length of hospital stay and duration of thoracic catheter retention were 8 (IQR, 7-9) and 2 (IQR, 2-2) days, respectively. No rehospitalizations or readmissions occurred. In comparison to the traditional robotic-assisted and video-assisted surgery groups, the single-port robotic surgery group showed a shorter operative time and less blood loss. CONCLUSIONS: Single-port robotic thoracic surgery using the da Vinci single-port surgical system is safe and feasible for anatomical lung resection. Moreover, larger controlled studies are required to validate its effectiveness and compare its advantages with those of other surgical platforms. CLINICAL TRIAL REGISTRATION NUMBER: ClinicalTrials.gov; NCT06246617.