Alessio Mariolo

Minimally invasive surgery is the gold standard to perform pulmonary lobectomy for early-stage non-small cell lung cancer. Recently, non-intubated video-assisted thoracoscopic surgery (NI-VATS), based on spontaneous ventilation under sedation and regional anaesthesia, has emerged as less invasive alternative to conventional anaesthesia, reporting several benefits but its application in major pulmonary resection remains controversial. We present the first report of robotic-assisted surgery (RATS) to perform a right lower lobectomy with radical lymph-node dissection in a non-intubated patient presenting a pulmonary adenocarcinoma. In our experience, this approach is feasible, combining the ergonomic and precision advantages of robotic technology with the potential physiological benefits of spontaneous ventilation further reducing the invasiveness of both surgery and anaesthesia This innovative combination may be defined as non-intubated robotic-assisted thoracic surgery: NI-RATS.

Sup. Fig. S9. Gating strategy for sorting EPCAM+CD45- cells after TEC digestion

Sup. Fig. S2. Quality control for T cells scRNA-seq

Supp. Fig. S3. Filtering of Thymocytes dataset

Sup. Fig. S1. Gating strategy for the characterization of hematopoietic CD45+ cells (pediatric sample Ped4 shown as example).

Supplementary table S2D : Raw DEG of scRNA-seq from TEC

Supplementary Table S5. Conditions for antibodies for the MICSSS (Multiplexed Immunohistochemical Consecutive Staining on Single Slide).

Supplementary Table S3: Quality and chain metrics for scTCR-seq (paired with scRNA-seq)

Sup. Fig. S5. Description of most immature T cells precursors, Early Thymic Precursors (ETP) CD3-CD34+ cells from Alive DUMP-CD45+: CD3-CD34+ cells.

Sup. Fig. S15. Expression of cytokines involved in thymocyte migration.