Abstract
OBJECTIVES: The integration of robot-assisted thoracic surgery (RATS) and uniportal video-assisted thoracic surgery (VATS) is poised to become a key direction for future advancements. The SHURUI single-port (SP) Robotic Surgery System, China's first domestically developed SP endoscopic system, has shown promise in urological and gynaecological surgeries but lacks thoracic application data. This study evaluates its safety and efficacy in anatomical lung resection. METHODS: A prospective single-centre trial enrolled 15 patients undergoing robotic pulmonary resection. The SHURUI system, featuring serpentine-arm instruments with dual continuum mechanisms, was deployed via a fifth/sixth intercostal incision. Primary endpoints included the non-conversion rate and the incidence of device-related or potentially device-related surgical complications meeting Clavien-Dindo grade 3 or higher criteria; secondary endpoints encompassed operative time, blood loss, pain scores, surgeon satisfaction, the incidence of adverse events, transfusion rates, 30-day readmission rates, 30-day reoperation rates, and 30-day mortality. RESULTS: All procedures (8 lobectomies, 5 segmentectomies, and 2 sleeve lobectomies) achieved 100% non-conversion, with one case requiring an auxiliary port. Median total operative time, port creation time, docking time, and console time were 174 minutes (117-335), 14 minutes (8-30), 4 minutes (3-6), and 117 minutes (56-233), respectively. Blood loss was 100 mL (10-300), and the median hospital stay was 5 days (3-12). Postoperative pain scores according to the numerical rating scale (NRS) were 3, 3, and 2 at 1 hour, 24 hours, and 72 hours. Surgeons reported 95/100 median satisfaction. Two minor complications (prolonged air leak, anaemia) resolved conservatively; one readmission for pleural effusion required thoracentesis. No mortality was observed within the 30-day postoperative period. CONCLUSIONS: This study demonstrates the feasibility and acceptable safety of using the SHURUI SP robotic surgery system for anatomical lung resection. CLINICAL REGISTRATION NUMBER: The study protocol was registered at http://www.chictr.org.cn/ (ChiCTR2400084046).