{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:42:21Z","timestamp":1787870541507,"version":"build-2784847793"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Japan Medical Education Foundation through a Research Grant for Medical Education","award":["J2203"],"award-info":[{"award-number":["J2203"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Robotic-assisted thoracic surgery segmentectomy is increasingly used; however, comprehensive reports on robotic-specific intraoperative complications remain limited. This study analysed intraoperative complications during robotic-assisted lung segmentectomy across different indications, emphasizing factors unique to robotic surgery\u2014limited visualization, lack of tactile feedback, instrument interference, and team communication\u2014and described effective management strategies derived from detailed video-based review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of 215 consecutive patients (169 with primary lung cancer, 38 with metastatic lung tumours, and 8 with other diseases) who underwent robotic-assisted thoracic surgery segmentectomy between July 2020 to March 2024 was conducted. Operative records and videos were reviewed to identify intraoperative complications, and detailed video-based analyses were performed to determine injury mechanisms and causes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Intraoperative complications occurred in 19 patients (8.8%), primarily involving injuries to the pulmonary artery (n\u2009=\u20099, 4.2%), bronchi (n\u2009=\u20094, 1.9%), pulmonary vein (n\u2009=\u20092, 0.9%), and pleura (n\u2009=\u20094, 1.9%). Robotic-specific complications, attributed to limited visualization, lack of tactile feedback, stapler-related tension, instrument interference, and miscommunication, accounted for 3.3% (7 cases). All complications were managed successfully without blood transfusion or thoracotomy conversion using fibrin sealant patches, direct suturing, or additional subsegmental resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Video analyses identified robotic-specific challenges\u2014limited visualization, lack of tactile feedback, instrument trouble, and miscommunication. Targeted refinements in port positioning, stapling techniques, and structured simulation training improved the safety of robotic-assisted segmentectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf475","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:54:20Z","timestamp":1766148860000},"source":"Crossref","is-referenced-by-count":1,"title":["Video Analysis of Intraoperative Complications and Management in Robotic Lung Segmentectomy"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1457-2902","authenticated-orcid":false,"given":"Daisuke","family":"Nakamura","sequence":"first","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9460-0696","authenticated-orcid":false,"given":"Takashi","family":"Eguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, The University of Texas Southwestern Medical Center , Dallas, TX, 75390","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijun","family":"Xing","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5807-3558","authenticated-orcid":false,"given":"Shuji","family":"Mishima","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Terada","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Hara","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Kumeda","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Miura","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4640-5690","authenticated-orcid":false,"given":"Kazutoshi","family":"Hamanaka","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 390-8621,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-5174","authenticated-orcid":false,"given":"Kimihiro","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine , Matsumoto 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