Initial single-center experience with robot-assisted single-port major pulmonary resection: a retrospective study.

Background: The da Vinci Single-Port (SP) system is a robotic platform designed to facilitate uniportal surgery. This study aimed to evaluate the feasibility and safety of the da Vinci SP system for major pulmonary resections. Methods: We retrospectively reviewed patients with non-small cell lung cancer who underwent lobectomy or segmentectomy using the da Vinci SP system between August 2023 and June 2025. All procedures were performed through a uniportal subcostal incision. The primary endpoint was procedural feasibility, defined as completion of the planned operation without conversion to an alternative surgical approach or the addition of any supplemental ports. Secondary endpoints included safety and perioperative outcomes. Results: Nine patients were included: 8 (88.9%) had clinical stage I disease, and 1 (11.1%) with clinical stage IIB received neoadjuvant chemoimmunotherapy. The median age was 55.0 (range, 40.0-70.0) years, and 6 patients (66.7%) were women. Lobectomy was performed in 7 patients (77.8%), and segmentectomy in 2 (22.2%). The median operative and console times were 198.0 (range, 141.0-248.0) min and 151.0 (range, 105.0-190.0) min, respectively. All procedures were completed without conversion, and complete resection was achieved in all cases. The median pathologic tumor size was 20.0 (range, 0.0-40.0) mm. A median of 8.0 lymph node (LN) stations and 22.0 LNs were harvested. No Clavien-Dindo grade ≥ III complications occurred. One patient (11.1%) developed chylothorax, which was managed conservatively. The median durations of chest tube drainage and hospital stay were 3 and 4 days, respectively. Conclusions: Robot-assisted SP major pulmonary resections via a uniportal subcostal approach appear feasible and safe, demonstrating acceptable short-term postoperative outcomes.