WCLC 2025 - Posters & ePosters-EP.14.19 A Single Institution Retrospective Analysis of Mediastinal Tumor Resections Utilizing Robotic-Assisted Surgery

Pdf Summary

This retrospective single-institution study from Fukuoka University evaluated the feasibility and safety of robotic-assisted thoracoscopic surgery (RATS) for mediastinal tumor resections using three robotic platforms: da Vinci, Saroa, and hinotori. Since RATS for mediastinal tumors has been covered by insurance in Japan since 2018, the authors analyzed cases performed between April 2019 and April 2025 utilizing a sub-xiphoid surgical approach aimed at replicating the surgical view of median sternotomy.<br /><br />The study included 94 patients (da Vinci n=84, Saroa n=7, hinotori n=3). The median ages ranged from 61 to 69 years without significant differences among groups. Median console times were around 110–130 minutes, and median total operation time ranged from 156 to 206 minutes, with no statistically significant differences among robots. Average blood loss was minimal (0 to 46.6 mL), and postoperative hospital stay averaged 5–6 days. Tumor sizes and types, including thymomas and thymic cysts, were comparable across groups. Conversion to sternotomy was rare. The sub-xiphoid approach enabled a surgical view similar to median sternotomy and was associated with favorable postoperative outcomes, consistent with prior literature showing shorter hospital stays and less pain compared to lateral approaches.<br /><br />The study highlights that RATS via sub-xiphoid approach using diverse robotic platforms is a safe, feasible option for mediastinal tumor resections, applicable to various tumor types. Limitations include the retrospective design, single-center scope, small sample size—especially for newer robots—and assessment limited to short-term outcomes.<br /><br />In conclusion, robotic-assisted mediastinal tumor resection is a viable surgical approach warranting further investigation, particularly to evaluate long-term oncological and functional outcomes. This study supports expanding the use of varied robotic systems for thoracic surgery in Japan and potentially elsewhere.

Asset Subtitle

Yuichiro Ueda

Meta Tag

Speaker Yuichiro Ueda

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

robotic-assisted thoracoscopic surgery

mediastinal tumor resection

sub-xiphoid surgical approach

da Vinci robotic system

Saroa robotic platform

hinotori robotic system

thoracic surgery Japan

retrospective single-institution study

postoperative outcomes

mediastinal tumors