Robotic assisted sleeve lobectomy with the use of barbed sutures

Anastomosis in bronchoplasty using continuous suturing has become widely accepted. However, especially in VATS and robotic assisted thoracic surgery (RATS) it is difficult to maintain a continuous traction of suture over the circumference. In addition, the lack of haptic feedback on the current robotic systems might even further complicate the precise and constant maintenance of traction. Recent reports of using absorbable barbed suture materials in open and VATS surgery were published with promising results. We adopted and standardized the application of barbed sutures (Stratafix, Jonhson & Johnson, USA). There were no intraoperative difficulties such as cutting, loosening or tailing the suture.