Robotic-Assisted Pleurectomy is a Safe and Effective Surgical Treatment for Spontaneous Pneumothorax

Introduction: Spontaneous pneumothorax is a common thoracic surgical problem. To prevent recurrence, surgical options include blebectomy, mechanical or chemical pleurodesis, pleurectomy, or a combination of these operations. Pleurectomy is associated with lower recurrence rates but may be technically challenging via video-assisted thoracoscopic surgery. We report the first series of robotic-assisted pleurectomy (RAP) for spontaneous pneumothorax.<br /> Methods: A retrospective, single-center analysis was conducted on consecutive patients undergoing RAP for spontaneous pneumothorax from 2017 to 2023. Patients with prior surgery on the same side for pneumothorax were excluded. Demographics, comorbidities, functional status, intraoperative and perioperative variables were collected. 30d readmission, 30-d mortality, and recurrence were recorded.<br /> Results: Thirty-six patients underwent RAP during the study period with a median followup of 36 mo. Patients had a median age of 41.5 (interquartile range [IQR] 21.5-68) y and were mostly male (80.6%) and past smokers (44.4%) with 66.6% having a primary spontaneous pneumothorax. The median time to chest tube removal was 3 d (IQR 2-3) and the median length of stay was two days (IQR 2-4). Complications occurred in seven patients with the majority (85.7%) having a grade 2 Clavien-Dindo classification score. There was no 30d mortality or recurrence. Conclusions:Robotic-assisted pleurectomy for spontaneous pneumothorax is a safe andeffective operation that can be used to prevent future recurrence.<br /> (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AItraining, and similar technologies.