ArticleJTCVS open2026
Perioperative outcomes of extended robotic-assisted thoracic surgery with combined resection of adjacent structures.
Article in JTCVS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Objective: Extended robotic-assisted thoracic surgery (E-RATS) involving combined resection of adjacent structures remains uncommon, and consolidated reports are limited. This study aimed to describe our institutional early experience with E-RATS and evaluate perioperative outcomes, including the role of hybrid techniques. Methods: We retrospectively reviewed a prospectively maintained database of patients who underwent planned E-RATS between January 2017 and October 2024. E-RATS was defined as robotic pulmonary resection combined with bronchoplasty, pulmonary arterioplasty, or resection of adjacent structures. A hybrid approach was defined as planned use of a small thoracotomy solely for pulmonary artery clamping and/or chest wall resection, with all other procedures performed robotically. Patients converted to full thoracotomy were excluded. Perioperative outcomes were analyzed descriptively. Results: Eighteen patients (1.4% of 1276 robotic resections) were included. Procedures comprised bronchoplasty (n = 9), pulmonary arterioplasty (n = 6), and combined resection of the chest wall, diaphragm, or pericardium. Median operative time was 255 minutes, and median blood loss was 10 mL. Major postoperative complications (Clavien-Dindo grade ≥III) occurred in 4 patients (22%). Postoperative pain was assessed using a numerical rating scale on postoperative day 1 and is reported descriptively. All resections achieved negative margins, and no 90-day mortality was observed. Conclusions: In this single-institution early experience, extended robotic-assisted thoracic surgery, including selected hybrid procedures, was technically feasible and associated with acceptable perioperative outcomes. These findings provide descriptive and educational insight into the application of robotic-assisted techniques for selected complex thoracic resections.
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