Simultaneous Ligation of Vessels During Robotic Right Upper Lobectomy

BACKGROUND: Herein, we reported a new technique as the simultaneous ligation of vessels after bronchus section that could facilitate the achievement of Robotic-Assisted Thoracic Surgery (RATS) Right Upper Lobectomy (RUL). METHODS: The clinical data of all consecutive patients undergoing RATS RUL for management of early-stage Non-Small Cell Lung Cancer (NSCLC) were included in the study. Patients were divided into 2 groups based on whether RUL was performed by simultaneous ligation of vessels (Simultaneous Ligation Group) or by traditional single isolation-ligation technique (Control group). The inter-group differences regarding operative and peri-operative outcomes were statistically compared to assess the feasibility and safety of the procedure. RESULTS: Simultaneous ligation (n = 7) compared to control group (n = 37) was associated with a significant reduction of operative time (127 ± 56 min vs 178 ± 78.5 min; P = .01) and with a lower number of staplers used (3.4 ± 1.1 vs 7.5 ± 2.4; P = .001) while no significant differences were found regarding the number of resected LN station (P = .76) and of resected LN (P = .75); blood loss (P = .69); daily chest drainage output (P = .73); and length of chest drainage (P = .81) and of hospital stay (P = .86). The median follow-up was 11 months (ranged from 2 to 18 months); no recurrence was observed. CONCLUSIONS: Simultaneous ligation of vessels represented a viable option for surgeons in challenging cases, when a standard technique was difficult to perform.