Total Robotic Resection for Superior Sulcus Tumors: Technical Description and Case Series.

Background: Minimally invasive superior sulcus tumor (SST) resections have been described, but have been limited to a hybrid approach. We describe our technique and experience of total robotic resection of SST with video. Methods: We performed a single-institutional retrospective review of the patients who underwent total robotic resection for SST from 2018 to 2023. Total robotic resection for SST was defined as the surgical resection of the lobe and chest wall by a total intracorporeal approach without chest wall resection through an additional incision. Results: During the study period, 7 of 19 patients (37%) with SST underwent induction therapy and proceeded to total robotic resection. Of these, 2 of the 7 cases (29%) were converted to open, and the other 5 (71%) were completed through a total robotic approach (right: n = 4, left: n = 1). No patients required chest wall reconstruction. There were no in-hospital or 90-day deaths, including the patients converted to open. Conclusions: Total robotic approach to SST appears feasible and safe, and our early data suggest outcomes similar to open approaches. Although offering a minimally invasive approach to these operations may decrease the morbidity of these operations, additional studies with longer-term follow-up and comparison with open series are required to understand the potential benefits and/or risks of these procedures.