Robot-Assisted Thoracoscopic Surgery Can Be Safely Performed in Patients With Obesity from the Early Stages of Implementation.

OBJECTIVE

This study aimed to compare the perioperative outcomes of robot-assisted thoracoscopic surgery (RATS) and conventional video-assisted thoracoscopic surgery (VATS) for lung cancer in patients with obesity.

METHODS

Anatomical pulmonary lobectomy or segmentectomy performed at a single institution from April 2018 to September 2023 in patients with obesity (body mass index ≥25 kg/m2) were statistically compared in terms of perioperative clinical factors including operative time, blood loss, chest tube duration, pain score, intraoperative events, and early postoperative complications between RATS and VATS.

RESULTS

In all, 89 patients were evaluated; 43 underwent RATS and 46 underwent VATS. All RATS procedures were performed using the da Vinci Xi system. Patient characteristics were comparable between the 2 groups. The operative time, blood loss, number of dissected lymph nodes, intraoperative events, and conversion rate to open thoracotomy were similar between the 2 groups. The frequencies of postoperative complications and chest tube placement duration between the groups were also similar. The median pain scores were slightly higher in the RATS group on postoperative day 1 but were equivalent between the 2 groups on postoperative day 7. The RATS group had a shorter postoperative hospital stay than the VATS group (P < 0.01).

CONCLUSIONS

A surgical team proficient in conventional VATS can safely introduce RATS in patients with obesity and lung cancer with equivalent perioperative outcomes.