Robotic lobectomy: Experience with 638 consecutive cases

BACKGROUND: Robotic lobectomy has been evolving over the past decade and has been shown to be an oncologically acceptable procedure. We evaluated our experience with robotic lobectomy for the treatment of early-stage lung cancer. METHODS: We performed a retrospective review of prospectively accrued patients at our institution who underwent robotic lobectomy for early-stage lung cancer from February 2004 to July 2019, RESULTS: Of 3304 consecutive patients who underwent a robotic operation by a single surgeon, 638 underwent robotic lobectomy for early-stage primary non-small cell lung cancer (NSCLC; stages I and II). The 427 (67%) men and 211 (33%) women had a median age of 69 y (range 41-86), and 567 (89 %) were former or current smokers. The median operative time was 176 minutes (range 160-456), the median chest tube time was 3 days (2-8), the median air leak time was 0 days (0-3), and the median length of stay was 3 days (1-26). The median tumor size was 2.6 cm (range 06-3.4). The mean number of nodes recovered was 14 ± 3. Pathologic upstaging was noted in 121 patients (19%). Minor complications were observed in 133 patients (21%). Conversion to thoracotomy occurred in 11 (1.7%) patients. Mortality was 0.5%. CONCLUSION: Robotic lobectomy is a safe, minimally invasive procedure that replicates the oncologic and technical principles of thoracotomy for the treatment of lung cancer.