Robotic-assisted single-port system for pulmonary lobectomy: A prospective feasibility study

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 170; no. 1; pp. 54 - 60.e1
• Main Authors: Zervos, Michael, Park, Bernard J., Marshall, M. Blair, Wee, Jon O., Soukiasian, Harmik J., Hartwig, Matthew G., Rajaram, Ravi, Rice, David C.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2025
• Subjects: Aged; Feasibility Studies; Female; Humans; lobectomy; lung cancer; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Male; Middle Aged; Pneumonectomy - adverse effects; Pneumonectomy - instrumentation; Pneumonectomy - methods; Prospective Studies; robot; Robotic Surgical Procedures - adverse effects; Robotic Surgical Procedures - instrumentation; Robotic Surgical Procedures - methods; single port; subcostal; Thoracic Surgery, Video-Assisted - adverse effects; Thoracic Surgery, Video-Assisted - instrumentation; Treatment Outcome; uniportal; United States; United States; PP; lobectomy; VATS; AE; ITT; RATS; IQR; EBL; ASA; lung cancer; robot; LOS; subcostal; single port; IRB; uniportal; SP
• ISSN: 0022-5223; 1097-685X; 1097-685X
• DOI: 10.1016/j.jtcvs.2025.04.004

To confirm the feasibility and safety of the da Vinci single-port (SP) System to perform pulmonary lobectomy procedures using a subcostal, uniportal approach. A prospective multicenter, single-arm clinical study evaluating the performance and safety of the da Vinci SP Surgical System for pulmonary lobectomy. Nineteen subjects (benign, n = 1; malignant, n = 18) were enrolled at 6 academic medical centers in the United States and underwent robotic-assisted SP subcostal lobectomy. All SP lobectomy procedures were completed without conversion to multiport thoracoscopic/robotic or open approaches. No intraoperative adverse events (AEs) or unanticipated adverse device effects were observed; 13 postoperative AEs commonly experienced after lobectomy were reported, 4 of which were Clavien-Dindo grade III. The rate of complete resection (ie, R0) was 100%. The median number of nodal stations sampled was 6.5 (interquartile range [IQR], 6.0-8.0) with a median of 17.5 (IQR, 7.0-34.0) nodes resected per patient. Robotic SP subcostal lobectomy is feasible and is associated with acceptable perioperative and oncologic quality outcomes. Additional clinical experience and research are needed to determine whether this alternative single incision approach has clinical benefit compared to standard transthoracic, multiport robotic lobectomy.