単孔式RATS肺切除術17例の経験と工夫

Experiences in 17 Cases of Uniportal Robot-assisted Lung Resection for Lung Cancer

単孔式ロボット支援下（URATS）肺切除術はGonzalez-Rivasらが報告し，中華人民共和国や欧州で普及しつつあるda Vinci Xiシステム（Intuitive Surgical社）による新たな肺切除術のアプローチである1，2）．われわれはGonzalez-Rivasの主催したセミナーで直接指導を受け，独自の工夫も加えて2022年12月～2024年3月にURATS肺切除術を17例に実施したので報告する．

We performed uniportal robot-assisted thoracoscopic surgery （URATS） lung resection for primary lung cancer in 17 cases （lobectomy for 8 and segmentectomy for 9）. The three robotic arms for a camera, left hand, and right hand were inserted into the thoracic cavity through a 4.0 cm port centered on the mid-axillary line at the sixth or seventh intercostal space. In order to reduce interference between the arms, three flare cannulas with the grounding pad connector removed were used in 16 cases with the approval of the institutional ethics committee and the consent of each patient. R0 resection was successfully performed in all cases and postoperative complications included pneumonia in one case and prolonged air leak in one case. The initial results of URATS lung resection were favorable.