title: Robotic lobectomy: The first Indian report.
abstract: BACKGROUND
  Even today, open lobectomy involves significant morbidity. Video-assisted thoracic surgery (VATS) lobectomy results in lesser blood loss, pain, and hospital stay compared to lobectomy by thoracotomy. Despite being an excellent procedure in expert hands, VATS lobectomy is associated with a longer learning curve because of its inherent basic limitations. The da Vinci surgical system was developed essentially to overcome these limitations. In this study, we report our initial experience with robotic pulmonary resections using the Completely Portal approach with four arms. To the best of our knowledge this is the first series of robotic lobectomy reported from India.
  
  
  METHODS
  Data on patient characteristics, operative details, complications, and postoperative recovery were collected in a prospective manner for patients who underwent Robotic Lung resection at our institution between March 2012 and April 2014 for various indications including both benign and malignant cases.
  
  
  RESULTS
  Between March 2012 to April 2014, a total of 13 patients were taken up for Robotic Lobectomy with a median age of 57 years. The median operative time was 210 min with a blood loss of 33 ml. R0 clearance was achieved in all patients with malignant disease. The median lymph node yield in nine patients with malignant disease was 19 (range 11-40). There was one intra-operative complication and two postoperative complications. The median hospital stay was 7 days with median duration to chest tube removal being 3 days.
  
  
  CONCLUSIONS
  Robotic lobectomy is feasible and safe. It appears to be oncologically sound surgical treatment for early-stage lung cancer. Comparable benefits over VATS needs to be further evaluated by long-term studies.
authors.affiliation: Department of Thoracic Surgery, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Thoracic Surgery, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Belal Bin
authors.initials: BB
authors.lastname: Asaf
authors.affiliation: Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Robert James
authors.initials: RJ
authors.lastname: Cerfolio
authors.affiliation: Department of Anaesthsiology and Pain Management, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Jayshree
authors.initials: J
authors.lastname: Sood
authors.affiliation: Additional Director, Medical Services, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Reena
authors.initials: R
authors.lastname: Kumar
keywords: Lobectomy; lung cancer; robot; robot assisted thoracic surgery; robotic lobectomy