Early clinical outcomes of thoracic surgery using the Saroa surgical system: a single institution retrospective observational study of perioperative outcomes.

BACKGROUND: The Saroa surgical system is a novel robot-assisted surgical platform characterized by pneumatic actuation and quantitative haptic feedback. Data on its broader consecutive use during early thoracic surgical implementation remain limited. This study evaluated the early perioperative safety and implementation-related outcomes of this platform. METHODS: This single-center retrospective observational study included 72 consecutive patients who underwent thoracic surgery using the Saroa surgical system between July 2023 and April 2026. The primary outcome was postoperative complications of Clavien-Dindo grade II or higher within 30 days. Secondary outcomes included intraoperative adverse events, conversion, perioperative mortality, and system log-based reboot-requiring protective stop events. RESULTS: The cohort included 43 lobectomies, 20 segmentectomies, and 9 mediastinal tumor resections. Clavien-Dindo grade II or higher complications occurred in 13 patients (18.1%). Among anatomical pulmonary resection cases, the most common complication was prolonged air leak, occurring in 6 of 63 patients (9.5%). No 30- or 90-day mortality or Clavien-Dindo grade IIIb or higher complications were observed. Intraoperative adverse events occurred in 3 patients (4.2%), all involving vascular injury. Overall conversion occurred in 7 patients (9.7%), including conversion to video-assisted thoracic surgery in 5 and thoracotomy in 2; no emergency conversion occurred. Reboot-requiring protective stop events occurred 30 times in 16 patients. No complications were directly attributed to these events, although one device-related conversion occurred. CONCLUSIONS: Early thoracic surgical implementation of the Saroa surgical system demonstrated an acceptable perioperative safety profile in this consecutive series. Evaluation of novel robotic platforms should include not only conventional perioperative outcomes but also system log-based troubleshooting, system refinement, conversion readiness, and team-based workflow during adoption.