Robotic Lobectomy with a Single Robotic Stapler from One 12-mm Port: A Multi-institutional Study [Published online in advanced , by J-STAGE]

[Advanced Published online The Keio Journal of Medicine, by J-STAGE]
<Title:> Robotic Lobectomy with a Single Robotic Stapler from One 12-mm Port: A Multi-institutional Study
<Author(s):> Yoshimasa Inoue, Koichi Fujiu, Tetsuya Endo, Rurika Hamanaka, Hiroto Tanaka, Hidefumi Takei, Makoto Oda
<Abstract:> Introduction of the robotic stapler has allowed robotic lobectomy to be performed from a surgical console in complete autonomy. The robotic stapler fits a 12-mm port, which is larger than the standard 8-mm port and increases the risk of postoperative pain. However, in many cases, to cover all possible angles of approach, two 12-mm ports are preferably used. However, limiting instrument inventory and simplifying surgical procedures are also desirable to reduce costs. In a multicenter study, we assessed the feasibility of robotic lobectomy with a single type of robotic stapler [SureForm45 Curved-Tip (SF45C); Intuitive Surgical Inc.] inserted through one 12-mm port placed at the anterior tip of the lower intercostal space. We also investigated the potential cost savings of using an additional 60-mm stapler for interlobar division. A total of 135 lobectomy cases were enrolled. In all cases, all stapling procedures were completed using the SF45C inserted from the designated 12-mm port. We found that it was potentially less expensive to use the SureForm60 stapler if more than six SF45C reloads were needed for interlobar division. However, in our series, only 1 case (0.7%) met this requirement. The use of a single type of stapler from one 12-mm port in a robotic lobectomy is technically feasible. This approach may be expected to allow for surgical simplification, minimize the risk of postoperative pain, and reduce inventory costs.
<Keywords:> robotic lung resection, robotic stapler, postoperative pain, cost
<URL:> https://www.jstage.jst.go.jp/article/kjm/advpub/0/advpub_2024-0003-OA/_html