{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:40:36Z","timestamp":1792482036006,"version":"4.5.0"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>There are 2 methods for surgical stapling during robotic lobectomy (RL): handheld assistant-driven (HH) and robotic (RS) staplers. This study aims to compare the clinical and financial outcomes between these HH and RS approaches used in RL for lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Between January 1, 2021, and December 31, 2022, patients who underwent elective RL for lung cancer were identified and extracted from the PINC AI\u2122 Healthcare Database. To compare RS and HH outcomes, 1:1 nearest-neighbor propensity score matching (PSM) was conducted using patient and provider characteristics. Chi-square, Fisher\u2019s exact, and\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      tests were used to examine outcomes after PSM. Multivariable generalized linear models (GLMs) with respective gamma or binomial distribution and log-link function were also performed to examine outcome variations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 2,511 inpatient admissions following RL were included (14.4% HH and 85.6% RS), and 361 matched pairs were generated by PSM. Adjusted outcomes showed no significant differences in air leak, postoperative pneumothorax, or length of stay between matched pairs. There was a 12.5% versus 5.5% rate of bleeding associated with RS versus HH (odds ratio = 2.4, 95% confidence interval [CI]: 1.4, 4.2,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001); however, GLMs minimized the discrepancy. Using RS had higher inpatient costs than HH (mean difference [MD] = $7,024 USD, 95% CI: $4,495, $9,554,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Operating room (OR) time was longer for RS than HH (MD = 25 min, 95% CI: 12, 38,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Assistant-driven HH used in RL for lung cancer appears at least as safe and effective as RS but may provide increased OR efficiency and cost savings. In this era of fiscal austerity, these findings cannot be overlooked.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845261488443","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T04:49:00Z","timestamp":1792298940000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Surgeon, the Robot, and the Stapler: Comparison of Stapling Strategies During Robotic Lobectomy"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-8582","authenticated-orcid":false,"given":"John F.","family":"Lazar","sequence":"first","affiliation":[{"name":"University of Tennessee Health Science Center College of Medicine\u2013Nashville Campus, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2781-2629","authenticated-orcid":false,"given":"I-Wen","family":"Pan","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research, Medtronic plc, Mounds View, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Abbas","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Lazzaro","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Robert Wood Johnson Barnabas Health, Long Branch, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inderpal","family":"Sarkaria","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Spier","sequence":"additional","affiliation":[{"name":"New York University Long Island School of Medicine, Mineola, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1543-2872","authenticated-orcid":false,"given":"Sudish","family":"Murthy","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(02)00102-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.06.020"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2022.07.014"},{"key":"e_1_3_2_5_2","first-page":"12","article-title":"Robotic vs. traditional stapler use in robotic portal anatomic lung resection","volume":"4","author":"Phillips JD","year":"2020","unstructured":"Phillips JD, Fay KA, Hasson RM, et al. Robotic vs. traditional stapler use in robotic portal anatomic lung resection. Mini-invasive Surg 2020; 4: 12.","journal-title":"Mini-invasive Surg"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/15569845211040814"},{"key":"e_1_3_2_7_2","unstructured":"PINC AI\u2122 Applied Sciences Premier Inc. PINC AI\u2122 Healthcare Database: data that informs and performs (White Paper) https:\/\/offers.pinc-ai.com\/PINC-AI-Healthcare-Database-White-Paper-LP.html (2024 accessed 11 December 2025)."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.03.13"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-22-192"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S133830"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-018-0679-z"},{"key":"e_1_3_2_12_2","unstructured":"Consumer price index for hospital services in the US. Washington DC: US Bureau of Labor Statistics 2024."},{"key":"e_1_3_2_13_2","first-page":"188","article-title":"Charlson Comorbidity Index: ICD-9 update and ICD-10 translation","volume":"12","author":"Glasheen WP","year":"2019","unstructured":"Glasheen WP, Cordier T, Gumpina R, et al. Charlson Comorbidity Index: ICD-9 update and ICD-10 translation. Am Health Drug Benefits 2019; 12: 188\u2013197.","journal-title":"Am Health Drug Benefits"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261488443","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845261488443","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845261488443","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:18:22Z","timestamp":1792480702000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845261488443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,17]]},"references-count":12,"alternative-id":["10.1177\/15569845261488443"],"URL":"https:\/\/doi.org\/10.1177\/15569845261488443","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,17]]},"article-number":"15569845261488443"}}