Li Chengqiang, Chen Xiang, Wang Xipeng, Guo Wei, Zhang Yajie, Chen Fengxia, Li Hecheng
Department of Thoracic Surgery and School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Department of Thoracic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China.
Interdiscip Cardiovasc Thorac Surg. 2025 Jul 3;40(7). doi: 10.1093/icvts/ivaf161.
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).
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.
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.
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.
ClinicalTrials.gov; NCT06246617.
机器人系统通过三维可视化、可操作性和震颤过滤功能改进了胸外科手术。本研究评估了达芬奇单孔手术系统在中国人群中进行胸外科手术的有效性和安全性（ClinicalTrials.gov；NCT06246617）。
2023年12月至2024年5月期间，对适合微创肺切除的高恶性肺结节患者使用单孔机器人系统进行解剖性肺切除。还评估了围手术期和短期随访结果。另外还获取了另一项临床试验（RVlob试验：NCT03134534）的临床数据用于比较。
所有15例患者手术均成功，术中无需中转，不过3例因体重指数高和解剖结构复杂需要额外增加一个辅助切口。此外，术中中位失血量和手术时间分别为15（四分位间距[IQR]，10 - 37.5）毫升和100（IQR，86 - 119）分钟。中位住院时间和胸管留置时间分别为8（IQR，7 - 9）天和2（IQR，2 - 2）天。未发生再次住院或再次入院情况。与传统机器人辅助手术组和电视辅助手术组相比，单孔机器人手术组的手术时间更短，失血量更少。
使用达芬奇单孔手术系统进行单孔机器人胸外科手术对于解剖性肺切除是安全可行的。此外，需要更大规模的对照研究来验证其有效性，并将其优势与其他手术平台进行比较。
ClinicalTrials.gov；NCT06246617。
