To retrospectively analyze the clinical data of patients undergoing robot-assisted segmentectomy since the implementation of the Da Vinci robotic surgical system at a single center, summarizing its safety, feasibility, and perioperative outcomes, thereby providing data support for the promotion and optimization of this technique.

A total of 472 patients who underwent robot-assisted anatomical segmentectomy in Shanghai Pulmonary Hospital between October 2020 and December 2023 were included. Baseline patient characteristics, surgical details, perioperative indicators, and complications were collected. The primary endpoint was perioperative complications. Secondary endpoints included conversion rate to thoracotomy, operative time, intraoperative blood loss, rates of 30-day readmission and 90-day mortality.

All 472 procedures were completed successfully without conversion to thoracotomy or mortality. The mean patient age was (57.45±11.88) years. The overall surgical volume showed an increasing trend. The dual-port approach was predominant (72.0%), with a rising proportion of single-port surgeries. The mean operative time was (100.19±41.93) min. Fitting of the learning curve was performed based on operative time. Intraoperative blood loss was <100 mL in 98.7% of cases, with only one patient (0.2%) requiring intraoperative blood transfusion. The mean postoperative hospital stay was (3.29±1.54) days. The overall complication rate was low, mainly consisting of persistent air leak (18 patients, 3.8%). The 30-day readmission rate was 0.6%, with no deaths within 90 days. Single-port group had a significantly shorter operative time, hospital stay, and early drainage than the multi-port group.

This study preliminarily confirms that robot-assisted segmentectomy is safe and feasible in experienced centers, with a low perioperative complication rate and favorable short-term outcomes. Robotic surgery is a safe and viable alternative to video-assisted thoracoscopic segmentectomy, although its long-term oncological efficacy requires further validation by prospective studies..