Anatomical lung resection learning curve: comparison between new modular robotic surgical system and VATS technique

<bold>OBJECTIVES:</bold> This study aims to compare the learning curve of two surgeons performing anatomical lung resections with a new modular robotic system (Versius Surgical System, CMR) and with a standard VATS technique. <bold>Methods:</bold> The first consecutive 49 Versius anatomical lung resections (from November 2021 to January 2024) were compared with the corresponding 49 first triportal VATS cases (from October 2010 to September 2015), performed by the same two surgeons. We analyzed the retrospectively collected data by CuSum method. <bold>Results:</bold> Demographic data of VATS and Versius groups was comparable. The average operative time of the Versius and VATS groups was 248±56 and 228±49 minutes respectively (p-value = 0,027). From the CuSum plots (reported in figure 1), it appears that the learning curve is faster for the VATS group. Nevertheless, the effective robotic operating time is about 70% of the whole reported time, which includes the time needed for instrument port training and robot positioning. Important findings concern time to chest tube removal and length of hospital stay: both data seem to favor RATS. <bold>Conclusions:</bold> Surgeons and the whole equipe seem to need more time to learn new approaches using different surgical instruments. Notwithstanding a longer normalization of operating times for the Versius group, the new modular robotic platform can ensure excellent post-operative outcomes. <fig><object-id>erj;64/suppl_68/PA1421/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>