Single-center retrospective study on the clinical application of multi-arm robotic-assisted uniportal video-assisted thoracic surgery

This research aims to consolidate clinical experiences with hybrid multi-arm robotic-assisted uniportal thoracoscopic surgery (H-URATS) employing endoscopic staplers and assess its safety and feasibility. A retrospective review was conducted on the clinical records of 128 patients treated with H-URATS at the Department of Thoracic Surgery II, Xinjiang Medical University Affiliated Tumor Hospital, between January and December 2024. The cohort included 52 men and 76 women, with an average age of 57.11 +/- 11.61 years. All cases involved multi-arm robotic-assisted uniportal thoracoscopic procedures. Out of 128 cases, 127 were successfully completed, with 1 conversion to thoracotomy due to severe intraoperative hemorrhage. The median operative duration was 160 (115, 232.5) min, including approximately 6 min for docking, and the median intraoperative blood loss was 30 (30-50) mL. The median duration for chest drainage was 4 (3, 5) days, while the median postoperative hospital stay was 5 (4, 6) days. The surgeries included 116 pulmonary resections and 12 resections of mediastinal tumors. There were no perioperative fatalities. Postoperative complications occurred in eight patients, including pulmonary infections, arrhythmias, type I respiratory failure, venous thrombosis, and pulmonary embolism, all of which were effectively managed. All patients were discharged in stable condition, and R0 resection was achieved in all instances. H-URATS represents a safe and practical approach for pulmonary and mediastinal tumor resections, with the potential for broader clinical use.