{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T20:16:09Z","timestamp":1775765769273,"version":"3.50.1"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Herein, we reported a new technique as the simultaneous ligation of vessels after bronchus section that could facilitate the achievement of Robotic-Assisted Thoracic Surgery (RATS) Right Upper Lobectomy (RUL).<\/jats:p>\n                  <jats:p>Methods: The clinical data of all consecutive patients undergoing RATS RUL for management of early-stage Non-Small Cell Lung Cancer (NSCLC) were included in the study. Patients were divided into 2 groups based on whether RUL was performed by simultaneous ligation of vessels (Simultaneous Ligation Group) or by traditional single isolation-ligation technique (Control group). The inter-group differences regarding operative and peri-operative outcomes were statistically compared to assess the feasibility and safety of the procedure.<\/jats:p>\n                  <jats:p>Results: Simultaneous ligation (n\u2009=\u20097) compared to control group (n\u2009=\u200937) was associated with a significant reduction of operative time (127\u2009\u00b1\u200956 min vs 178\u2009\u00b1\u200978.5 min; P\u2009=\u2009.01) and with a lower number of staplers used (3.4\u2009\u00b1\u20091.1 vs 7.5\u2009\u00b1\u20092.4; P\u2009=\u2009.001) while no significant differences were found regarding the number of resected LN station (P\u2009=\u2009.76) and of resected LN (P\u2009=\u2009.75); blood loss (P\u2009=\u2009.69); daily chest drainage output (P\u2009=\u2009.73); and length of chest drainage (P\u2009=\u2009.81) and of hospital stay (P\u2009=\u2009.86). The median follow-up was 11 months (ranged from 2 to 18 months); no recurrence was observed.<\/jats:p>\n                  <jats:p>Conclusions: Simultaneous ligation of vessels represented a viable option for surgeons in challenging cases, when a standard technique was difficult to perform.<\/jats:p>","DOI":"10.1093\/icvts\/ivag066","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:52:14Z","timestamp":1775044334000},"source":"Crossref","is-referenced-by-count":0,"title":["Simultaneous Ligation of Vessels During Robotic Right Upper Lobectomy"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0628-613X","authenticated-orcid":false,"given":"Alfonso","family":"Fiorelli","sequence":"first","affiliation":[{"name":"Thoracic Surgery Unit, University of Campania \u201cLuigi Vanvitelli\u201d , I-80138 Naples,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, University of Campania \u201cLuigi Vanvitelli\u201d , I-80138 Naples,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Capasso","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, University of Campania \u201cLuigi Vanvitelli\u201d , I-80138 Naples,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Ciaravola","sequence":"additional","affiliation":[{"name":"Anesthesiology Unit, University of Campania \u201cLuigi Vanvitelli\u201d , 83100 Naples,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Coppolino","sequence":"additional","affiliation":[{"name":"Anesthesiology Unit, University of Campania \u201cLuigi Vanvitelli\u201d , 83100 Naples,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Anesthesiology Unit, University of Campania \u201cLuigi Vanvitelli\u201d , 83100 Naples,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"2026040915170632200_ivag066-B1","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1007\/s00464-018-06659-w","article-title":"Simplified synchronous disconnection of pulmonary arteries and veins for right upper lobectomy","volume":"33","author":"Lin","year":"2019","journal-title":"Surg Endosc"},{"key":"2026040915170632200_ivag066-B2","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1055\/s-0037-1620276","article-title":"The bronchus first and vessels simultaneously stapled technique: a safe and simple method for video-assisted right upper lobe lobectomy","volume":"67","author":"Xu","year":"2019","journal-title":"Thorac Cardiovasc Surg"},{"key":"2026040915170632200_ivag066-B3","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1055\/s-0042-1742362","article-title":"Bleeding during learning curve of thoracoscopic lobectomy: CUSUM analysis results","volume":"71","author":"Fiorelli","year":"2023","journal-title":"Thorac Cardiovasc Surg"},{"key":"2026040915170632200_ivag066-B4","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1186\/s13019-021-01658-w","article-title":"Vein-first versus artery-first ligation procedure for lung cancer surgery: an updated review","volume":"16","author":"Zhao","year":"2021","journal-title":"J Cardiothorac Surg"},{"key":"2026040915170632200_ivag066-B5","doi-asserted-by":"crossref","first-page":"e70092","DOI":"10.1111\/1759-7714.70092","article-title":"Thoracoscopic massive bleeding after firing mediastinal trunk of the pulmonary artery with calcified lymph node","volume":"16","author":"Fiorelli","year":"2025","journal-title":"Thorac Cancer"},{"key":"2026040915170632200_ivag066-B6","doi-asserted-by":"crossref","first-page":"102310","DOI":"10.1016\/j.suronc.2025.102310","article-title":"Impact of minimally invasive surgical approach on oncological completeness of resection in lung cancer surgery","volume":"64","author":"Forcada","year":"2026","journal-title":"Surg Oncol"},{"key":"2026040915170632200_ivag066-B7","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":"Kuo","year":"2017","journal-title":"J Thorac Dis"},{"key":"2026040915170632200_ivag066-B8","doi-asserted-by":"crossref","first-page":"705662","DOI":"10.3389\/frobt.2021.705662","article-title":"Tactile sensing for minimally invasive surgery: conventional methods and potential emerging tactile technologies","volume":"8","author":"Othman","year":"2021","journal-title":"Front Robot AI"}],"container-title":["Interdisciplinary CardioVascular and Thoracic 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