Eastern Cardiothoracic Surgical Society

Robotic Segmentectomy versus Thoracoscopic Segmentectomy: Comparing Intraoperative Results
Philip A. Erwin, Sharon Ben-Or, William D. Bolton, James E. Stephenson, Greenville Health System, Greenville, SC, USA

OBJECTIVE: Recent studies have shown robotic-assisted thoracoscopic surgery segmentectomy to be safe in select patients with pulmonary lesions. The purpose of this study was to compare intra-operative and post-operative outcomes of robotic segmentectomy with video-assisted thoracoscopic surgery (VATS) segmentectomy. This is the largest series reported in the literature comparing robotic with VATS for segmentectomies.

METHODS: A retrospective review was undertaken for consecutive patients who underwent a robotic segmentectomy (n=147) or VATS segmentectomy (n=33) between January 2007 and July 2018. Our primary endpoints included operative time and estimated blood loss (EBL). We also compared the first 100 robotic segmentectomies to the second 47 cases to determine if there was a difference in outcomes with increased experience. Data was analyzed using the Chi-square tests.

RESULTS: There was a significant difference between groups in operative time (robotic=224 min, VATS=212 min; P<0.001), EBL (robotic=108 mL, VATS=250 mL; P<0.001). A 64 minute reduction in operative time was observed between the early and late robotic groups (244 min vs. 180 min; P< 0.01).

CONCLUSIONS: We found robotic segmentectomy to be a safe procedure with similar postoperative outcomes when compared to VATS segmentectomy. Robotic segmentectomy also allows for a quicker operation with less blood loss.