A robotic left S1+2c subsegmentectomy using preoperative simulation.

Although there are reports describing segmentectomy by a robotic approach, reports describing robotic subsegmentectomy are rare because this procedure requires more precise anatomical knowledge and exposure of subsegmental pulmonary vessels and bronchi. However, the robotic approach has several advantages, including a high-definition 3-dimensional surgical view and precise motion without tremor, which may allow us to perform the subsegmentectomy more easily. Considering these advantages of the robotic approach, we successfully performed a robotic left S1+2c segmentectomy with a short console time and a good postoperative course. We present the surgical steps of this procedure. In addition, the preoperative simulation method was useful to ensure a sufficient surgical margin. Because the robotic approach lacked tactile feedback, it was difficult to locate the target tumour intraoperatively by palpation compared with the conventional thoracoscopic approach. Finally, in this case, we obtained an adequate surgical margin using this preoperative simulation method.