UCLA Health surgeons have performed their first single-port robotic lobectomy, using a single incision below the rib cage to remove a cancerous lung lobe.
The technique aims to minimise nerve irritation, reduce post-operative pain and support faster recovery.
Thoracic surgeons at UCLA Health introduced the minimally invasive approach that enables an entire lung lobe to be removed through a single incision beneath the rib cage.
By accessing the chest through an incision below the rib cage, single-port robotic surgery aims to avoid the sensitive intercostal nerves that can become irritated during conventional approaches, potentially reducing post-operative pain and reliance on analgesia.
In a UCLA Health Q&A with Jay M Lee, surgical director of the Thoracic Oncology Program at UCLA Health and an investigator at the UCLA Health Jonsson Comprehensive Cancer Centre, he explains that the robotic system remains entirely under the surgeon’s control, with no autonomous movement.
He said: ‘With this new approach, we can perform the entire operation through a single incision below the rib cage. In our first case at UCLA, that incision was just 4cm, or about 1.6 inches. We can still remove the affected lung tissue and evaluate the surrounding lymph nodes to determine whether the cancer has spread.’
The procedure is performed using a single-port robotic system, with the surgeon controlling the instruments from a console while viewing a magnified, 3D image of the operative field.
The camera and surgical instruments are introduced through the same incision but can move independently within the chest, providing the dexterity and precision required for complex thoracic procedures.
A key component of the technology is a robotic stapler specifically designed for the single-port system. Controlled directly from the surgical console, it enables the surgeon to divide and seal blood vessels, airways and lung tissue without relying on an assistant to operate a separate stapling device.
Dr Lee added: ‘Not every patient with lung cancer will be a candidate for this approach. We carefully evaluate several factors, including the size and location of the tumour, whether the cancer has spread, the patient's lung and heart function, previous surgeries and their overall anatomy. Patients with certain early-stage lung cancers that can be safely removed with surgery may be good candidates. However, the decision is always individualised.
‘The most important consideration is making sure we can safely and completely remove the cancer. The number of incisions should never take priority over the quality or safety of the operation. For some patients, another minimally invasive approach or traditional surgery may be the better option.’
