Non-intubated robotic-assisted apicodorsal left lung segmentectomy (S¹⁺²b-c) for a non-small cell lung carcinoma.

Minimally invasive surgery is the standard of care for lung resections in patients with early-stage non-small cell lung cancer. Non-intubated thoracic surgery, relying on spontaneous ventilation under sedation and locoregional anaesthesia, has emerged as an alternative to general anaesthesia with potential advantages for patients. The application of non-intubated thoracic surgery to video-assisted thoracic surgery to perform anatomical lung resections has already been described and aims at merging the benefits of the two techniques to improve the patient postoperative course. Robotic-assisted thoracic surgery represents a further refinement of minimally invasive techniques, offering several advantages over video-assisted thoracic surgery in complex procedures. To the best of our knowledge, this is the first case of a robotic-assisted lung segmentectomy performed without endotracheal intubation and under locoregional anaesthesia and sedation.