{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:50:25Z","timestamp":1785887425114,"version":"3.56.0"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"abstract":"This study aims to assess the initial experience with a downsized bevel-cut trocar to enhance lung resection in robot-assisted thoracoscopic surgery (RATS). In addition, we provide a mathematical model to support the scientific rationale and functional advantages of this design.<\/jats:p>\n We analyzed the impact of trocar cannula diameter using software and conducted a retrospective review of patients who underwent lung resection using a modified bevel-cut trocar for uniportal or biportal RATS between July 2024 and February 2025. Perioperative and postoperative outcomes, including incision length, surgery duration, complications, and hospital stay, were compared with those of conventional trocar RATS.<\/jats:p>\n A total of 34 patients underwent RATS anatomical lung resection, including 12 with modified bevel-cut trocars and 22 with conventional trocars. Baseline demographic and clinical characteristics were comparable between groups. The modified trocar group had shorter utility incision lengths than the conventional trocar group (overall p\u2009<\u20090.001). Mean incision length was 3.75\u2009cm (range, 3.0\u20134.5) versus 6.0\u2009cm for uniportal RATS and 3.0\u2009cm versus 4.6\u2009cm (range, 4.0\u20136.0) for biportal RATS. In exploratory approach-specific comparisons, operative time was shorter in the modified trocar group for both uniportal and biportal RATS (p\u2009=\u20090.007 and p\u2009=\u20090.039, respectively), whereas this finding should be interpreted cautiously because of the small subgroup sizes and non-randomized approach selection. No conversion, major postoperative complication, or mortality occurred.<\/jats:p>\n The modified bevel-cut trocar offers a safer and more practical solution for performing uniportal or biportal RATS.<\/jats:p>","DOI":"10.1055\/a-2924-6258","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T22:51:25Z","timestamp":1785279085000},"source":"Crossref","is-referenced-by-count":0,"title":["Enhanced Trocar Design Optimizes Robotic-Assisted Lung Resection"],"prefix":"10.1055","author":[{"given":"Shuenn-Wen","family":"Kuo","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan","place":["Taipei"],"department":["Department of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jang-Ming","family":"Lee","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan","place":["Taipei"],"department":["Department of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5493-7673","authenticated-orcid":false,"given":"Pei-Ming","family":"Huang","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan","place":["Taipei"],"department":["Department of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"issue":"21","key":"ref1","doi-asserted-by":"crossref","first-page":"6471","DOI":"10.3390\/jcm11216471","article-title":"Robotic-assisted thoracoscopic (RATS) enucleation of esophageal mesenchymal tumors and foregut cysts","volume":"11","author":"Y H Chen","year":"2022","journal-title":"J Clin Med"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/SLA.0000000000002346","article-title":"Robotic versus video-assisted lobectomy\/segmentectomy for lung cancer: a meta-analysis","volume":"268","author":"H Liang","year":"2018","journal-title":"Ann Surg"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"3105","DOI":"10.21037\/jtd.2017.08.11","article-title":"Robot-assisted thoracic surgery for complex procedures","volume":"9","author":"S W Kuo","year":"2017","journal-title":"J Thorac Dis"},{"key":"ref4","first-page":"100362","article-title":"Learning curve in robotic-assisted lobectomy for non-small cell lung cancer is not steep after experience in video-assisted lobectomy; single-surgeon experience using cumulative sum analysis","volume":"27","author":"S E Andersson","year":"2021","journal-title":"Cancer Treat Res Commun"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.21037\/tlcr-21-207","article-title":"A uniportal right upper lobectomy by three-arm robotic-assisted thoracoscopic surgery using the da Vinci (Xi) Surgical System in the treatment of early-stage lung cancer","volume":"10","author":"Y Yang","year":"2021","journal-title":"Transl Lung Cancer Res"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1177\/17562872231177781","article-title":"New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology","volume":"15","author":"M Salkowski","year":"2023","journal-title":"Ther Adv Urol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s11701-024-01887-w","article-title":"Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes","volume":"18","author":"Y J Leang","year":"2024","journal-title":"J Robot Surg"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1016\/j.athoracsur.2021.09.061","article-title":"Robotic vs thoracoscopic anatomic lung resection in obese patients: a propensity-adjusted analysis","volume":"114","author":"C W Seder","year":"2022","journal-title":"Ann Thorac Surg"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.athoracsur.2021.10.067","article-title":"Conversion to thoracotomy during thoracoscopic vs robotic lobectomy: predictors and outcomes","volume":"114","author":"E L Servais","year":"2022","journal-title":"Ann Thorac Surg"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/ejcts\/ezab385","article-title":"The robotic surgery learning curve of a surgeon experienced in video-assisted thoracoscopic surgery compared with his own video-assisted thoracoscopic surgery learning curve for anatomical lung resections","volume":"61","author":"M T Gomez-Hernandez","year":"2022","journal-title":"Europ J Cardio-Thorac Surg"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2924-6258.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:16:46Z","timestamp":1785885406000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2924-6258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":10,"URL":"https:\/\/doi.org\/10.1055\/a-2924-6258","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7,28]]},"published":{"date-parts":[[2026,7,28]]}}}