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<p>Conventional robot-assisted thoracic surgery lacks haptic feedback, forcing surgeons to infer tissue tension visually. To address this limitation, we evaluated overall perioperative safety and the learning curve during early clinical implementation of Saroa, a pneumatically actuated surgical robot providing quantitative haptic feedback. Additionally, we examined the feasibility and short-term safety of selective direct pulmonary artery (PA) grasping. This retrospective study analyzed 92 lung cancer operations performed between April 2024 and January 2026. Direct PA grasping was performed selectively while the surgeon monitored the real-time force display, maintaining a peak grasping force of ≤ 2 N. The learning curve was assessed via console time, segmented regression, and CUSUM charts. Safety was evaluated using risk-adjusted cumulative sum (RA-CUSUM) for postoperative complications. The association between PA grasping and estimated blood loss (EBL) was assessed using propensity-score-based inverse probability of treatment weighting (IPTW) with double-robust estimation. Direct PA grasping was performed in 47 cases (70 sites) without PA-related injury, conversion, or reoperation. Median EBL was 10 mL (mean 16.3 mL). Postoperative non-contrast CT was obtained in 44 of 47 PA-grasp cases (median postoperative day 42) showing no vascular complications. Segmented regression estimated a breakpoint at case 74; mean console time after the breakpoint was 111.4 min. Overall, postoperative complications occurred in 15 of 92 cases (16.3%), and major complications occurred in 8 of 91 cases (8.8%); RA-CUSUM showed no deterioration in safety. During early clinical implementation of a pneumatically actuated surgical robot, the learning phase was navigated without an apparent deterioration in overall patient safety, and selective direct PA grasping was feasible in the short term.</p>

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Early clinical experience with Saroa, a pneumatically actuated surgical robot with quantitative haptic feedback, in robot-assisted thoracic surgery: safety, learning curve, and feasibility of direct pulmonary artery grasping

  • 期刊论文

  • 发表日期：

    2026年4月2日

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  • Kazuhiro Washio,
  • Kota Araki

摘要

Conventional robot-assisted thoracic surgery lacks haptic feedback, forcing surgeons to infer tissue tension visually. To address this limitation, we evaluated overall perioperative safety and the learning curve during early clinical implementation of Saroa, a pneumatically actuated surgical robot providing quantitative haptic feedback. Additionally, we examined the feasibility and short-term safety of selective direct pulmonary artery (PA) grasping. This retrospective study analyzed 92 lung cancer operations performed between April 2024 and January 2026. Direct PA grasping was performed selectively while the surgeon monitored the real-time force display, maintaining a peak grasping force of ≤ 2 N. The learning curve was assessed via console time, segmented regression, and CUSUM charts. Safety was evaluated using risk-adjusted cumulative sum (RA-CUSUM) for postoperative complications. The association between PA grasping and estimated blood loss (EBL) was assessed using propensity-score-based inverse probability of treatment weighting (IPTW) with double-robust estimation. Direct PA grasping was performed in 47 cases (70 sites) without PA-related injury, conversion, or reoperation. Median EBL was 10 mL (mean 16.3 mL). Postoperative non-contrast CT was obtained in 44 of 47 PA-grasp cases (median postoperative day 42) showing no vascular complications. Segmented regression estimated a breakpoint at case 74; mean console time after the breakpoint was 111.4 min. Overall, postoperative complications occurred in 15 of 92 cases (16.3%), and major complications occurred in 8 of 91 cases (8.8%); RA-CUSUM showed no deterioration in safety. During early clinical implementation of a pneumatically actuated surgical robot, the learning phase was navigated without an apparent deterioration in overall patient safety, and selective direct PA grasping was feasible in the short term.