Single-port robotic surgery for lung cancer
UCLA Health surgeons recently performed their first single-port robotic lobectomy, a procedure that removes cancerous lung tissue through a single 1.6-inch incision below the rib cage.
The purpose of this development is to mitigate post-surgical discomfort, decrease reliance on pain relief drugs, and facilitate a smoother transition for patients resuming their normal routines.
Traditional lobectomies often require open surgery with large incisions or multiple small cuts between the ribs. Because the spaces between the ribs contain sensitive nerves, traditional minimally invasive techniques can lead to nerve irritation and discomfort.
By using a single incision below the rib cage, surgeons can bypass these nerves.
“If we can perform the same cancer operation through a smaller incision, potentially reduce pain and help patients get back to the things they enjoy sooner, that’s meaningful progress,” said Jay M. Lee, MD, Surgical Director of the Thoracic Oncology Program at UCLA Health.
Robotic precision during lobectomy
During the procedure, the surgeon operates from a console, controlling robotic instruments that provide a magnified, three-dimensional view of the surgical area. The robotic system allows the camera and instruments to enter through the single incision and move in multiple directions through the anatomy.
A specialized robotic stapler allows the surgeon to seal blood vessels, airways, and lung tissue directly from the console. This integration removes the need for an assistant to operate a separate device, streamlining the process. Dr. Lee noted that the robot does not perform the surgery on its own; every movement remains under the direct control of the surgeon.
Surgeons evaluate factors to determine patient suitability
Not all lung cancer patients qualify for this specific robotic approach. Surgeons evaluate several individual factors, including tumor size, tumor location, whether the cancer has spread, and the patient’s overall heart and lung function.
“The most important consideration is making sure we can safely and completely remove the cancer,” Dr. Lee said. “The number of incisions should never take priority over the quality or safety of the operation.”
Recovery involves breathing exercises and walking, which clinicians encourage soon after the procedure to help lungs recover and reduce the risk of complications. Patients typically require a temporary chest tube to drain fluid and air while the lung heals. Pain management is individualized, with the clinical team aiming to reduce the need for opioid medications when appropriate.
Questions about the procedure
Who is a candidate for single-port robotic lobectomy?
Candidates may include patients with certain early-stage lung cancers that can be safely removed with surgery. Surgeons determine eligibility based on a review of the patient’s anatomy, lung and heart function, previous surgeries, and the location of the tumor.
How does this differ from standard robotic surgery?
Conventional robotic surgery typically utilizes several smaller incisions through the chest in between the ribs.
The single-port approach uses only one incision below the rib cage, which avoids the sensitive nerves located between the ribs.
What is the expected hospital stay?
Patients can expect their duration of hospitalization to be determined by their ability to breathe, ambulate, and control their pain, alongside the timing of chest tube extraction.
Future of thoracic surgical techniques
The integration of single-port technology at UCLA Health builds on a well-established robotic thoracic surgery program that already performs many robotic operations each year for lung cancer and other conditions involving the chest. As surgical instruments and techniques continue to improve, the focus remains on personalizing care to minimize the physical burden of treatment.
Dr. Lee observed that the goal of these advancements is not to perform every operation through one incision, but to choose the safest, most effective method for each patient. Researchers still need more research to understand the full impact of this technology.
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