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Phillips et al. Mini-invasive Surg 2020;4:12 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.02

Original Article Open Access

Robotic vs. traditional stapler use in robotic portal
anatomic lung resection

Joseph D. Phillips, Kayla A. Fay, Rian M. Hasson, Timothy M. Millington, David J. Finley

Section of Thoracic Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Correspondence to: Dr. Joseph D. Phillips, Thoracic Surgery, One Medical Center Dr, Lebanon, NH 03756, USA.
E-mail: joseph.d.phillips@hitchcock.org
How to cite this article: Phillips JD, Fay KA, Hasson RM, Millington TM, Finley DJ. Robotic vs. traditional stapler use in
robotic portal anatomic lung resection. Mini-invasive Surg 2020;4:12. http://dx.doi.org/10.20517/2574-1225.2020.02
Received: 2 Jan 2020 First Decision: 19 Jan 2020 Revised: 27 Jan 2020 Accepted: 3 Feb 2020 Published: 14 Feb 2020

Science Editor: Noriyoshi Sawabata Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Aim: Currently, there is a paucity of data comparing robotic to traditional video-assisted thoracic surgery stapling
devices and the effects on perioperative outcomes during robotic anatomic lung resection. We sought to investigate our
institutional experience with patients undergoing robotic anatomic lung resection stratified by the type of stapler used
over a contemporary period.

Methods: We performed a retrospective review of a prospectively maintained thoracic surgery database and evaluated
all patients who underwent robotic anatomic lung resection between January 2015 and December 2018. Patients were
grouped based on the type of stapler used during surgery and preoperative characteristics and intraoperative and
postoperative outcomes were compared.

Results: In total, 634 lung resections occurred during the study period. Of those, 236 met inclusion criteria, and 49 cases
(20.8%) fully utilized the robotic stapler. We found no clinically significant difference in preoperative or intraoperative
characteristics between groups, except operative time was longer in the robot stapler group. This was likely related to
surgeon learning curve. There were no differences between groups in postoperative outcomes or complications.

Conclusion: We found equivalent rates of complications, prolonged air leak, and chest tube duration between the two
groups. Based on our data, we recommend that surgeons use the stapling device with which they are most confident.

Keywords: Robotic stapler, robotic lung resection, lung cancer, EndoWrist®

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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