Comparison of lobectomy performed through Toumai surgical robot and da Vinci surgical robot in early-stage non-small cell lung cancer: a retrospective study of early perioperative results.

Background: Robotic-assisted thoracic surgery (RATS) is a safe and efficient minimally invasive thoracic approach compared to thoracotomy. Today, almost all thoracic procedures can be performed by RATS. In recent years, the Chinese government has issued some policies to support the development of domestic surgical robots, leading to the development of the Toumai surgical robot system. This study aimed to explore the application of the Toumai surgical robot in performing lobectomy for early-stage non-small cell lung cancer (NSCLC), and to compare its safety, surgical effect, and advantages or disadvantages compared with the mature da Vinci robotic surgical system.

Methods: Patients with early-stage NSCLC undergoing robotic-assisted lobectomy in our center between November 2021 and December 2021 were enrolled in the study; Surgeries were performed through the Toumai surgical robot and the da Vinci robotic system. Anatomical lobectomy and systematic lymph node (LN) dissection were conducted in all patients. Baseline and perioperative outcomes were analyzed to compare the two methods.

Results: The combined 19 patients from the Toumai group (n=9) and the da Vinci group (n=10) were enrolled and eligible for analyses. They had similar baseline characteristics, tumor characteristics, clinical stage, and pathological stage. Conversion to thoracotomy was not observed, and the operation time {95 minutes [interquartile range (IQR), 86.5-136.5 minutes] vs. 86 minutes (IQR, 81-102 minutes), P=0.178} and other perioperative outcomes were comparable in the two groups. There was no significant difference in the number of dissected LNs and lymphatic stations between both groups.

Conclusions: The application of Toumai surgical robot in lobectomy was preliminarily shown to be safe and effective. Compared with the mature da Vinci robotic surgery system, Toumai surgical robot had similar technical and surgical advantages, highlighting its suitability as an optional method for the new generation of robotic-assisted thoracoscopic surgery.