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Uniportal Robotic Right Lower Lobectomy

Tuesday, September 20, 2022

Waterhouse B, Dunning J. Uniportal Robotic Right Lower Lobectomy. September 2022. doi:10.25373/ctsnet.21165490

This video shows a uniportal robotic right lower lobectomy. The surgeons used uniportal robotic surgery, which represents a fusion of the advantages of uniportal VATS and robotic surgery, including wristed instrumentation and 3D vision.



In this case, the patient presented with a 6 cm right lower lobe tumor with adhesions. The uniportal incision was performed in the seventh space and the posterior part of the incision was at the vertex of the chest. The camera was then placed at the posterior part of the incision at 30 degrees down, and a bipolar was placed in the left hand and a Maryland in the right hand. For a right-sided lobectomy, arm one was inactivated, a camera was placed in arm two, and arm three was assigned to the left hand and arm four to the right hand on the manual console settings.

Because the arms do not clash, surgeons have a good view of the anatomy. This technique is quick and easy to perform, and it is faster than multiportal robotic surgery. It also allows more precise dissection compared to uniportal VATS surgery. The Intuitive stapling devices can also be used in the surgery without any issue. Leave your thoughts on this approach in the comments section below.

To see an interview Dr. Diego Gonzalez Rivas about uniportal robotic thoracic surgery, watch "The New Era of Uniportal Robotic Surgery." For a demonstration of the setup for this technique, check out "Uniportal Robotic Surgery: A Step-by-Step Guide to Setup."


This is an off-label use of the Intuitive Robotic system and all surgeons using this approach do so at their own risk. The opinions and views of Joel Dunning with regard to this technique are his own and do not represent the views of Intuitive surgical who are still evaluating this technique for safety and efficacy.

The information and views presented on represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.


Dear Dr.Waterhouse, The problem we met for single port robotic surgery is the narrowness of the intercostal space. How did you overcome this issue or it never bothered you? Thanks!
This is an excellent illustration of URATS lobectomy and an excellent promotion for this rather new technique! In this case the size of the tumor obviously reduced the impact of longer Uniport incision that is required compared to standard uniportal VATS. The Achilles heel obviously remains the need for a very experienced (if not senior surgeon) assistant at table-side. My main issue with this video is the disclaimer! Who decides what is on- and off-label? The Da Vinci is just a surgical instrument and as far as I know, we surgeons always take the final responsibility of our choice of instruments and what we do with them. So this should not stop experts like you and Diego to go on with this amazing experience!

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