# Semi‐Continuous Versus Continuous Suturing Techniques in Bronchial Anastomosis Following da Vinci Robotic‐Assisted Sleeve Lobectomy

## TL;DR

This study compares two suturing techniques in robotic lung surgery, finding that semi-continuous suturing is faster without increasing risks.

## Contribution

The study demonstrates that semi-continuous suturing is a safer and more efficient alternative to continuous suturing in bronchial anastomosis.

## Key findings

- Semi-continuous suturing reduced anastomotic time by 21 minutes compared to continuous suturing.
- No significant differences in complication rates, mortality, or recovery metrics were observed between the two techniques.

## Abstract

In robot‐assisted thoracoscopic (RATS) bronchial sleeve lobectomy, despite the continuous suturing (CS) technique's widespread adoption, the safety and advantages of the semi‐continuous suturing (SCS) technique remain inconclusive.

Patients undergoing RATS bronchial sleeve lobectomy for central Non‐Small Cell Lung Cancer (NSCLC) between January 2020 and December 2024 were retrospectively enrolled and stratified into two cohorts based on anastomotic technique: the CS group and the SCS group. Perioperative outcomes were compared between the two groups.

The SCS group (n = 18) demonstrated significantly shorter anastomotic time than the CS group (n = 14) (median 28 min [24–33] vs. 45 min [32–52]; p < 0.001), with a 21‐min reduction in operative time (median 135 min [110–185] vs. 156 min [138–212]; p = 0.040). No statistically significant differences were observed in: overall complication rates (anastomosis‐specific: 11.1% vs. 21.4%, p = 0.425; systemic: 22.2% vs. 42.9%, p = 0.212); 90‐day mortality (0% vs. 7.1%, p = 0.467); late stenosis rate (0% vs. 7.1%, p = 0.249) or reoperation rate (5.6% vs. 14.3%, p = 0.401); postoperative recovery metrics (extubation time and hospital stay, p > 0.05).

SCS can safely reduce bronchial anastomosis time in RATS sleeve resection and is recommended as the preferred technique for optimizing operative efficiency.

Semi‐continuous suturing significantly reduces bronchial anastomosis time during robotic sleeve lobectomy compared to continuous suturing, without increasing complication rates, offering a safer and more efficient technical option for bronchial reconstruction.