A robotic-assisted Pancoast tumour resection

Pancoast tumours, a rare subset of superior sulcus tumours, arise at the apex of the lung and pose significant surgical challenges due to their anatomical location and propensity to invade adjacent critical structures, including the brachial plexus, subclavian vessels and the thoracic spine. Historically, these tumours were considered inoperable, but advancements in multimodal treatment, including neoadjuvant chemoradiotherapy followed by surgical resection, have improved survival rates. Conventional open surgical techniques are associated with significant morbidity, prolonged recovery and suboptimal visualization of critical structures. Robotic-assisted thoracic surgery, particularly with the da Vinci Xi surgical system, offers enhanced three-dimensional visualization, dexterity and precision in confined spaces, potentially transforming the surgical management of these complex resections. This video tutorial explores the application of a robotic-assisted Pancoast tumour resection using the da Vinci Xi platform, focusing on perioperative management and patient outcomes.