Safety and Feasibility of Novel Single-Port Robotic-Assisted Lobectomy/Segmentectomy for Lung Cancer

Abstract

Background: Robotic-assisted thoracic surgery (RATS) has advanced lung cancer treatment with precise robotic arm maneuvers and 3-dimensional visualization. Whereas conventional RATS systems require multiple incisions, a uniportal approach is increasingly favored. However, current systems face challenges with maneuverability and incision size. The SHURUI single-portal (SP) robotic system (Beijing Shurui Technology Co, Ltd), with its total-flex single-arm design, addresses these limitations, especially for patients with narrow intercostal spaces or limited intrathoracic space.

Methods: This phase 1/2 single-arm registry trial assessed the safety and feasibility of lobectomy/segmentectomy using the SHURUI SP robotic system. The study enrolled patients aged 18 to 75 with lung cancer from November 2023 to April 2024. The SHURUI SP system's "deformable dual continuum mechanism" technology enabled precise surgical maneuvers, evaluating primary end points such as conversion rates, blood loss, lymph node retrieval, transfusion needs, and intraoperative complications.

Results: Thirty-five patients, median age 58 years, underwent lobectomy/segmentectomy, with successful procedures in all cases. No conversions to video-assisted thoracic surgery or open surgery were needed, and no additional trocars were used. Median operative time was 155 minutes, docking time was 3 minutes, and console time was 81 minutes. Median blood loss was 10 mL, with no transfusions required. The 30-day morbidity rate was 11.43%, with no major complications or rehospitalizations. All patients were discharged after a mean hospital stay of 4 days.

Conclusions: The SHURUI SP robotic system demonstrates safety and feasibility for RATS in lung cancer. A large-scale, multicenter randomized controlled trial is needed to further validate this technology's efficacy and safety across a broader patient population.