Robotic pulmonary lobectomy without using intercostal sites: The first case of lung cancer surgery using the da Vinci SP surgical system in Japan

Abstract

In the field of general thoracic surgery, multi-port robotic surgery and single-port thoracoscopic surgery have widely spread. The da Vinci SP surgical system, approved in September 2022, is a single-port system with only one robotic arm that is expected to further reduce invasiveness. The system is contra-indicated for cardiac surgery and an intercostal approach, and we report the first case of lung cancer surgery without an intercostal approach in Japan using this system. The patient was a 68-year-old man with 1.4 cm lung cancer, cT1bN0M0, in the lower lobe of his right lung. The operation was performed in a left lateral recumbent position, a 4 cm skin incision was placed below the costal arch, and an access port was created via the diaphragm. Three instruments and a camera were inserted from there, and a stapler was operated by an assistant with one instrument removed. The console time was 139 minutes with a small amount of blood loss, and the postoperative pain measured using a numeric rating scale was 0 to 1 from the first postoperative day.Lung cancer surgery using the da Vinci SP without intercostal sites was easy to perform and exhibited advantages in terms of postoperative pain and cosmetics.