Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspective

Objective: To introduce and evaluate the non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS), a novel technique designed to eliminate the need for skilled assistants by using all 4 robotic arms independently during anatomical lung surgery. Methods: Patients were...

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Main Authors: Hideki Ujiie, MD, PhD, FACS, FCCP, Hiroki Ebana, MD, PhD, Jun Suzuki, MD, PhD, Masato Chiba, MD, PhD, Hikaru Watanabe, MD, Aki Kobayashi, MD, PhD, Satoshi Shiono, MD, PhD, Yasuhiro Tsutani, MD, PhD, Tatsuya Kato, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-10-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250724003298
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author Hideki Ujiie, MD, PhD, FACS, FCCP
Hiroki Ebana, MD, PhD
Jun Suzuki, MD, PhD
Masato Chiba, MD, PhD
Hikaru Watanabe, MD
Aki Kobayashi, MD, PhD
Satoshi Shiono, MD, PhD
Yasuhiro Tsutani, MD, PhD
Tatsuya Kato, MD, PhD
author_facet Hideki Ujiie, MD, PhD, FACS, FCCP
Hiroki Ebana, MD, PhD
Jun Suzuki, MD, PhD
Masato Chiba, MD, PhD
Hikaru Watanabe, MD
Aki Kobayashi, MD, PhD
Satoshi Shiono, MD, PhD
Yasuhiro Tsutani, MD, PhD
Tatsuya Kato, MD, PhD
author_sort Hideki Ujiie, MD, PhD, FACS, FCCP
collection DOAJ
description Objective: To introduce and evaluate the non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS), a novel technique designed to eliminate the need for skilled assistants by using all 4 robotic arms independently during anatomical lung surgery. Methods: Patients were placed in the lateral decubitus position under general anesthesia with single-lung ventilation. The da Vinci Xi Surgical System was used, with specific configurations for right- and left-side operations. The neoDRATS technique used a 4-cm working port and a 1.8-cm secondary port, with detailed guidelines for optimal setup and robotic arm manipulation. Results: The neoDRATS approach demonstrated successful surgical outcomes without the need for a skilled assistant. The use of a 0° camera and careful placement of instruments minimized interference within the thoracic cavity. The technique provided smooth operability and minimized postoperative discomfort. Video demonstrations of right and left upper lobectomies are provided to illustrate the approach. Conclusions: NeoDRATS offers a practical, safe, and minimally invasive alternative to conventional multiportal and uniportal robotic-assisted thoracic surgeries. This technique simplifies the surgical process, particularly in settings with limited availability of skilled assistants, and represents a significant advancement in robotic thoracic surgery. Further refinement and clinical integration of neoDRATS are anticipated as robotic innovations continue to evolve.
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spelling doaj-art-77f847f3d42747b080247daa4a42182e2025-08-20T03:36:38ZengElsevierJTCVS Techniques2666-25072024-10-012714615010.1016/j.xjtc.2024.07.019Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspectiveHideki Ujiie, MD, PhD, FACS, FCCP0Hiroki Ebana, MD, PhD1Jun Suzuki, MD, PhD2Masato Chiba, MD, PhD3Hikaru Watanabe, MD4Aki Kobayashi, MD, PhD5Satoshi Shiono, MD, PhD6Yasuhiro Tsutani, MD, PhD7Tatsuya Kato, MD, PhD8Department of Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan; Address for reprints: Hideki Ujiie, MD, PhD, FACS, FCCP, Department of Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan.Department of Thoracic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, JapanDepartment of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, JapanDivision of Thoracic Surgery, Department of Surgery, Kindai University, Osaka, JapanDepartment of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, JapanDepartment of Thoracic Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, JapanDepartment of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, JapanDivision of Thoracic Surgery, Department of Surgery, Kindai University, Osaka, JapanDepartment of Thoracic Surgery, Hokkaido University Hospital, Sapporo, JapanObjective: To introduce and evaluate the non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS), a novel technique designed to eliminate the need for skilled assistants by using all 4 robotic arms independently during anatomical lung surgery. Methods: Patients were placed in the lateral decubitus position under general anesthesia with single-lung ventilation. The da Vinci Xi Surgical System was used, with specific configurations for right- and left-side operations. The neoDRATS technique used a 4-cm working port and a 1.8-cm secondary port, with detailed guidelines for optimal setup and robotic arm manipulation. Results: The neoDRATS approach demonstrated successful surgical outcomes without the need for a skilled assistant. The use of a 0° camera and careful placement of instruments minimized interference within the thoracic cavity. The technique provided smooth operability and minimized postoperative discomfort. Video demonstrations of right and left upper lobectomies are provided to illustrate the approach. Conclusions: NeoDRATS offers a practical, safe, and minimally invasive alternative to conventional multiportal and uniportal robotic-assisted thoracic surgeries. This technique simplifies the surgical process, particularly in settings with limited availability of skilled assistants, and represents a significant advancement in robotic thoracic surgery. Further refinement and clinical integration of neoDRATS are anticipated as robotic innovations continue to evolve.http://www.sciencedirect.com/science/article/pii/S2666250724003298robotic-assisted thoracic surgeryuniportal robotic-assisted thoracic surgerydual-portal robotic-assisted thoracic surgeryuniportal video-assisted thoracic surgery
spellingShingle Hideki Ujiie, MD, PhD, FACS, FCCP
Hiroki Ebana, MD, PhD
Jun Suzuki, MD, PhD
Masato Chiba, MD, PhD
Hikaru Watanabe, MD
Aki Kobayashi, MD, PhD
Satoshi Shiono, MD, PhD
Yasuhiro Tsutani, MD, PhD
Tatsuya Kato, MD, PhD
Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspective
JTCVS Techniques
robotic-assisted thoracic surgery
uniportal robotic-assisted thoracic surgery
dual-portal robotic-assisted thoracic surgery
uniportal video-assisted thoracic surgery
title Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspective
title_full Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspective
title_fullStr Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspective
title_full_unstemmed Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspective
title_short Developing novel non-assistant help operation in dual-portal robotic-assisted thoracic surgery (neoDRATS)Central MessagePerspective
title_sort developing novel non assistant help operation in dual portal robotic assisted thoracic surgery neodrats central messageperspective
topic robotic-assisted thoracic surgery
uniportal robotic-assisted thoracic surgery
dual-portal robotic-assisted thoracic surgery
uniportal video-assisted thoracic surgery
url http://www.sciencedirect.com/science/article/pii/S2666250724003298
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