title: One Hundred Planned Robotic Segmentectomies: Early Results, Technical Details, and Preferred Port Placement.
abstract: BACKGROUND
  Both robotic pulmonary operations and anatomic segmentectomy are being increasingly performed. The largest published series of anatomic robotic segmentectomy comprises 35 patients, and the specific details of port placement are poorly understood.
  
  
  METHODS
  This is a review of a consecutive series of patients from a single surgeon's prospective database. All patients in the study were scheduled to undergo robotic anatomic segmentectomy.
  
  
  RESULTS
  Between February 2010 and December 2014, 100 patients went to the operating room for a planned pulmonary segmentectomy. A robotic approach was chosen for all. Seven patients underwent conversion to robotic lobectomy, and the remaining 93 patients had an anatomic robotic segmentectomy. There were no conversions to thoracotomy. Indications for resection were lung cancer in 79 patients, metastatic lesions in 10 patients, fungal infections in 4 patients, and other conditions in 7 patients. The median age was 69 years, and 50 patients were men. The median blood loss was 20 mL (range, 10-120 mL), the median number of lymph nodes removed was 19, the median operative time was 1.28 hours (88 minutes), the median length of stay was 3 days, and major morbidity occurred in 2 patients (pneumonia in both). All had undergone R0 resection. There were no 30- or 90-day mortalities. Of the 79 patients with lung cancer, the median follow-up was 30 months, and 3 patients (3.4%) had recurrence in the operated lobe. Overall survival was 95% at 30 months.
  
  
  CONCLUSIONS
  Completely portal robotic anatomic segmentectomy is safe and effective and offers outstanding intraoperative 30-day and 90-day results. The recurrence rate is approximately 3% at 2.5 years.
authors: Division of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: rcerfolio@uabmc.edu.
authors: Robert J
authors: RJ
authors: Cerfolio
authors: Division of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
authors: Caroline
authors: C
authors: Watson
authors: Division of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
authors: Douglas J
authors: DJ
authors: Minnich
authors: Division of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
authors: Sandra
authors: S
authors: Calloway
authors: Division of Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
authors: Benjamin
authors: B
authors: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology; D009367:Neoplasm Staging; D061646:Operative Time; D061214:Patient Safety; D011013:Pneumonectomy / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D065287:Robotic Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome