二孔式RATSの初期経験

Early Experience with Dual-port Robot-assisted Thoracoscopic Surgery （DRATS）

近年，本邦での呼吸器外科領域におけるロボット手術は急速に広まっている．特に肺癌に対するロボット支援下手術（RATS）は2022年に年間6,500例以上が行われており，今後のさらなる増加が見込まれる1）．

Thoracoscopic surgery ［video-assisted thoracic surgery （VATS）］ for lung cancer has evolved to reduced port thoracoscopic surgery and uniportal VATS. Meanwhile, in Japan, robot-assisted thoracic surgery （RATS） for lung cancer is performed more than 6,500 cases annually in 2022, with numbers increasing each year. In Europe and China, reduced port and uniportal approaches are also being applied to RATS, indicating that reduced-port RATS and uniportal RATS may become more common in Japan in the future. Our institute got to perform RATS using the Da Vinci Si system in 2021. Since May 2023, we have introduced the Da Vinci Xi system and initiated dual-port RATS with two incisions. To date, we have safely conducted 63 surgeries using this approach. This report aims to describe the introduction, techniques, setup, equipment innovations, and precautions associated with dual-port RATS, while comparing it to the multi-port RATS previously conducted in our department.