Single-Port Robotic Thoracic Surgery: Study Reports Promising Outcomes in Over 100 Cases
South Korea: A recent study published in The Journal of Thoracic and Cardiovascular Surgery reports encouraging results from the first 115 cases of thoracic surgery performed using the da Vinci single-port (SP) robotic system, highlighting its safety and feasibility across a range of procedures.
The research was led by Jun Hee Lee from the Department of Thoracic and Cardiovascular Surgery at Guro Hospital, Korea University College of Medicine, Seoul.
The study, conducted between November 2020 and June 2023, retrospectively analyzed patient characteristics, intraoperative metrics, and postoperative outcomes to assess the practical application of the single-port robotic system in thoracic surgery. The procedures included thymectomy (41 patients), mediastinal mass excision (13), anatomical pulmonary resections such as lobectomy and segmentectomy (54), esophagectomy (5), and enucleation of esophageal submucosal tumors (2).
Key Findings:
- Operative times and postoperative recovery varied based on procedure complexity.
- Thymectomy cases averaged 152.9 ± 6.7 minutes, with chest tubes removed after 1.2 ± 0.5 days.
- Mediastinal mass excisions averaged 93.3 ± 26.5 minutes, with chest tube removal the next day.
- Anatomical pulmonary resections required 187.2 ± 55.8 minutes on average, with chest tubes maintained for 2.5 ± 1.5 days.
- Esophagectomy cases were the longest and most complex, averaging 485 ± 111.9 minutes, with chest tube duration of 12 ± 4.6 days.
- Enucleation of esophageal submucosal tumors averaged 170 ± 30 minutes, with chest tubes removed after approximately 5.5 days.
- No procedures required conversion to open thoracotomy or sternotomy.
- Only one patient needed conversion to video-assisted thoracic surgery.
- An additional port was required in just two cases.
- Only two patients experienced severe postoperative complications above grade IIIa, indicating a favorable safety profile.
The findings demonstrate that the single-port robotic system is capable of performing a broad spectrum of thoracic procedures, including technically demanding operations such as anatomical lung resections and esophagectomies. The minimal need for conversion or additional ports highlights the precision and control provided by the SP robotic platform.
The study emphasizes that continued advancements in robotic instruments and techniques are likely to expand the scope of complex thoracic surgeries that can be safely performed using minimally invasive approaches. The researchers note that the SP system allows for improved ergonomics, enhanced visualization, and precise instrument maneuverability, which may translate into shorter recovery times and reduced postoperative morbidity for patients.
This initial experience with the da Vinci single-port robotic system indicates that it is both feasible and safe for a variety of thoracic procedures. As robotic technology continues to evolve, it promises to further refine surgical outcomes and potentially redefine standards of care in thoracic surgery.
Reference:
Lee JH, Park TH, Kim HK. Robotic thoracic surgery using the single-port robotic system: Initial experience with more than 100 cases. J Thorac Cardiovasc Surg. 2024 Dec;168(6):1513-1522.e2. doi: 10.1016/j.jtcvs.2024.03.005. Epub 2024 Apr 28. PMID: 38678475.
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