A practical approach to procedural planning for robot-assisted segmentectomy using a lobectomy-based surgical simulator

Preoperative planning for robot-assisted segmentectomy requires accurate understanding of segmental anatomy and the sequence of vascular and bronchial division. Although three-dimensional computed tomography provides detailed anatomical information, it does not allow stepwise prediction of intraoperative anatomical changes. We applied a lobectomy-based da Vinci surgical simulator for preoperative planning of robot-assisted apical-anterior segmentectomy. A 62-year-old woman with a 10-mm pulmonary nodule suspected to be stage IA1 non-small cell lung cancer underwent the procedure. The method focuses on rehearsing the sequence of dissection and anticipating post-division anatomical relationships rather than replicating patient-specific anatomy. Although the procedure can be performed without simulation, this approach may provide additional value by enabling procedural rehearsal and reducing intraoperative uncertainty. The simulated workflow closely corresponded to intraoperative findings, suggesting that this approach may serve as a practical adjunct to conventional imaging in selected cases.