ArticleFrontiers in surgery2026
Largest single-institution series of robotic pneumonectomy.
Article in Frontiers in surgery, 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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Abstract
Background: Minimally invasive pneumonectomy via robotic or video-assisted platforms is not yet widely adopted. Rates of conversion-to-thoracotomy and 90-day mortality are reported at 30%-50% and 12%, respectively. We describe our experience with the largest single-institution consecutive series of robotic pneumonectomy. Methods: This is a retrospective review of prospective database of a consecutive (non-selected) series of patients who underwent robotic pneumonectomy from January 2019 to December 2024 at our institution. Results: There were 21 patients (67% male) with median age 70 (range 15-79), DLCO 76% (range 48%-106%), and FEV1 76% (range 44%-126%). Indication for pneumonectomy was cancer in 17 patients (81%), of which 15 (88%) had a primary lung cancer. Four patients (19%) had destroyed lung from infection, and six (29%) underwent completion pneumonectomy. Thirteen (76%) of the 17 cancer patients had neoadjuvant therapy, including chemotherapy (11 patients), immunotherapy (10 patients), and radiation therapy (6 patients). A robotic approach was selected for all patients, with planned conversion-to-open in two patients (9%). There were no intraoperative transfusions. Median chest tube duration was one day (range 1-4). Median length of stay was five days (range 1-25). Thirty-day readmission was 19% (4 patients). Thirty-day morbidity was 19%, including atrial fibrillation in two patients, hemothorax in one patient, and chylothorax in one patient. Thirty-day mortality was 0% and 90-day mortality was 5% (one patient). Conclusion: Pneumonectomy can be performed safely and effectively robotically even in high-risk patients with previous ipsilateral thoracotomy and/or neoadjuvant chemo-, immuno-, or radio-therapy. We demonstrate that a robotic approach enables minimal unplanned conversion-to-thoracotomy, no blood transfusions and excellent short-term outcomes. Our pre-, intra- and post-operative strategies are shared.
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