This video will demonstrate a robotic lobectomy for a RUL lung cancer. In video-assisted lobectomy literature, the incidence of thoracotomy is 5-10%.

Patients are positioned in a left-lateral decubitus position, with the table tilted posteriorly, flexed and in reverse trendelenberg. This facilitates exposure of hilar structures. A 3-armed daVinci robotic system is used with an additional assistant's port for stapling, suctioning, and introducing sutures. A ultrasonic shears is used for the lymphadenectomy and hilar dissections. The upper lobe pulmonary vein, artery and bronchus are divided with a stapler, with the bronchus being divided with a 45mm x 4.1mm endostapler. The fissure is completed using the same size stapler as for the bronchial division.

In the first 21 patients, the median hospital stay was 4 days. Chest tubes were removed after a median of 2.5 days. Oncologic evaluation demonstrated the median number of lymph nodes harvested was 10 (range: 2-54), and there have been no local recurrences at a median follow-up of 7 months.

Robotic-assisted lobectomies for lung cancer are safe and feasible. The 3-dimensional visibility and multiple arcs of rotation may allow a less traumatic and more precise dissection reducing the need to for thoracotomy.