{"title":"Uniportal robotic thoracic surgery - an early Indian experience.","authors":"Ajay Narasimhan, Manimaran Samidurai, Narasimhan Raghupathi, Ganapathy Arumugam Chandrasekaran","doi":"10.1007/s12055-024-01862-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Thoracic surgery has been conventionally performed via thoracotomy over many years. However, over the past few decades, lung surgery has evolved from open to minimally invasive surgery. Our robotic thoracic surgery programme started in October 2022. Since we were already performing uniportal video-assisted thoracic surgery (Uniportal VATS), we found it difficult to get oriented to the multi-port approach. So we decided to perform uniportal robot-assisted thoracic surgery (URATS). This article represents our initial experience in URATS.</p><p><strong>Methods: </strong>We analysed the data of people who underwent URATS at our hospital. Twenty-one patients were included in this study. This was a retrospective study. Out of the 21 patients, 14 patients underwent surgery for benign conditions and 7 patients underwent surgery for malignancy. Thirteen patients underwent lobectomy, 1 patient underwent segmentectomy, 3 patients underwent wedge resection, 3 patients underwent mediastinal mass excision, and 1 patient underwent bronchogenic cyst excision. Out of the lobectomy group, 6 patients had benign conditions, the other 6 being operated for malignancy. All surgeries were performed by a single console surgeon using the da Vinci Xi robotic platform and the same assistant at the bedside.</p><p><strong>Results: </strong>There was no conversion to a multiport robotic thoracic surgery or thoracotomy in our series. The average console time for the entire study group was 177.9 min. The average instrument active time for the entire study group was 130.5 min. The median instrument count per case in our study was 4. The average console time for lobectomy was 231.53 min. The average instrument active time for lobectomy was 174 min.</p><p><strong>Conclusions: </strong>We conclude that, in appropriate patients, Uniportal RATS can be a safe and feasible alternative to other minimally invasive techniques in both benign and malignant conditions.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01862-y.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 3","pages":"288-293"},"PeriodicalIF":0.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832869/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Thoracic and Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12055-024-01862-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/23 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Thoracic surgery has been conventionally performed via thoracotomy over many years. However, over the past few decades, lung surgery has evolved from open to minimally invasive surgery. Our robotic thoracic surgery programme started in October 2022. Since we were already performing uniportal video-assisted thoracic surgery (Uniportal VATS), we found it difficult to get oriented to the multi-port approach. So we decided to perform uniportal robot-assisted thoracic surgery (URATS). This article represents our initial experience in URATS.
Methods: We analysed the data of people who underwent URATS at our hospital. Twenty-one patients were included in this study. This was a retrospective study. Out of the 21 patients, 14 patients underwent surgery for benign conditions and 7 patients underwent surgery for malignancy. Thirteen patients underwent lobectomy, 1 patient underwent segmentectomy, 3 patients underwent wedge resection, 3 patients underwent mediastinal mass excision, and 1 patient underwent bronchogenic cyst excision. Out of the lobectomy group, 6 patients had benign conditions, the other 6 being operated for malignancy. All surgeries were performed by a single console surgeon using the da Vinci Xi robotic platform and the same assistant at the bedside.
Results: There was no conversion to a multiport robotic thoracic surgery or thoracotomy in our series. The average console time for the entire study group was 177.9 min. The average instrument active time for the entire study group was 130.5 min. The median instrument count per case in our study was 4. The average console time for lobectomy was 231.53 min. The average instrument active time for lobectomy was 174 min.
Conclusions: We conclude that, in appropriate patients, Uniportal RATS can be a safe and feasible alternative to other minimally invasive techniques in both benign and malignant conditions.
Graphical abstract:
Supplementary information: The online version contains supplementary material available at 10.1007/s12055-024-01862-y.
期刊介绍:
The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.