Feasibility of Uniport Robotic-Assisted Thoracic Surgery for Lung Cancer: Comparison with Multiport Robotic-Assisted Thoracic Surgery

Background: Background: Conventional robot-assisted thoracic surgery (RATS) pulmonary resection has been performed using a multiport approach; however, there is a growing trend toward reducing the number of ports.This study aims to evaluate the safety and feasibility of uniport RATS compared to multiport RATS.Methods: We retrospectively reviewed patients with non-small cell lung cancer who underwent RATS pulmonary resection between June 2022 and December 2024.Perioperative outcomes were analyzed and compared between uniport and multiport RATS.Results: A total of 102 patients were included in this study, with all surgeries performed by a single surgeon.Among them, 21 patients (20.6%) underwent uniport RATS, while 81 patients (79.4%) underwent multiport RATS.Baseline characteristics were similar between the 2 groups.All procedures achieved complete resection, and no conversions were observed.The surgical extent, histologic type, number of harvested lymph nodes, and harvested lymph node stations were comparable between the 2 groups.However, the operation time was shorter in the uniport RATS group (122.0 [113.0-130.0]min vs. 143.0min [119.0-167.0],p=0.037).There were no significant differences in chest drainage duration, postoperative hospital stay, or complication rates.However, postoperative pain scores were significantly lower in the uniport RATS group on postoperative days 0, 1, and 2. In our institution, a stepwise reduction in the number of ports was achieved and uniport RATS was successfully implemented.Over time, the proportion of uniport RATS procedures steadily increased. Conclusion:The early outcomes of uniport RATS are comparable to those of multiport RATS.Although reducing the number of ports requires a learning curve, uniport RATS is a safe and feasible technique.