A Robotic Left Lower Lobe Sleeve Lobectomy With Bronchoplasty Using the Fissureless Technique After Neoadjuvant Immunochemotherapy

Robotic bronchoplastic procedures offer technical advantages over thoracoscopy, particularly in complex situations involving dense fissures or posttreatment fibrosis. We describe a 60-year-old man with squamous cell carcinoma who underwent robotic left lower lobe sleeve lobectomy with bronchoplasty by the fissureless technique after neoadjuvant immunochemotherapy. Preoperative imaging showed tumor regression and an incomplete fissure, with bronchoscopy confirming left main bronchial invasion. The robotic platform enabled precise dissection and anastomosis with continuous barbed suturing. The postoperative course was uneventful, and pathologic examination revealed ypT1c N2b M0 disease. This case demonstrates the feasibility of integrating the fissureless technique into complex robotic bronchoplastic surgery.