Robotic-assisted lung cancer surgery: A look at its advantages and potential drawbacks
Robotic-assisted lobectomy, a minimally invasive approach to lung cancer surgery, is gaining popularity for its potential advantages over traditional open chest surgery and video-assisted thoracoscopic surgery (VATS).
A surgeon may perform one of three types of lung cancer surgery using robotic technology: lobectomy, wedge resection, or segmentation. Each procedure has its unique benefits, with robotic lobectomy offering a significant reduction in postoperative complications compared to VATS.
Robotic lobectomy involves the removal of the entire affected lobe of the lung. Studies have shown a link between lobectomy and higher survival rates for people with small cell lung cancer. A study in The Annals of Thoracic Surgery found that robotic lobectomy led to lower complication rates and shorter hospital stays compared to open chest lobectomy.
The procedure is performed using the da Vinci surgical system, which provides a 3D HD camera and tiny rotating instruments. The surgeon sits at a console and makes small hand movements, which are translated into tiny movements by the surgical instruments inside the lungs. This setup offers the surgeon a better view and greater accuracy of movement compared to VATS.
Robotic lobectomy typically results in a shorter hospital stay, with a person usually staying in the hospital for 4 days and recovering at home within 2-3 weeks. This is in contrast to open chest surgery, which requires a longer hospital stay due to increased need for intensive care, respiratory therapy, and prolonged hospitalization.
When compared to VATS, RATS is associated with shorter operative times, lower rates of postoperative complications, less intraoperative blood loss, and quicker recovery. Both RATS and VATS show similar oncological outcomes, including comparable lymph node status and pathological cancer stages.
Doctors may recommend either a wedge resection or segmentation for people with limited lung reserve or early-stage lung cancer. These two options are called sublobar resections. Segmentation involves the removal of more tissue than during the wedge resection but less tissue than in the lobectomy.
It's important to note that all surgery, even a minimally invasive operation for lung cancer, carries risks such as air leakage from the lungs, bleeding, infections, pain, and abnormal heartbeats. A person may be a candidate for robotic-assisted surgery if their tumor is close to the outside of the lungs and not attached to blood vessels.
In summary, robotic-assisted lobectomy combines the oncologic effectiveness of VATS with advantages including shorter surgery duration and fewer complications. Both approaches provide superior perioperative recovery profiles versus open chest surgery. These findings suggest RATS as a promising minimally invasive option for lung cancer surgery with favorable long-term outcomes.
[1] Kang YJ, Kim JH, Lee JH, et al. Robotic-Assisted Lung Resection for Early-Stage Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis. Ann Thorac Surg. 2015;99(3):677-685. [2] Cheng SC, Chen YC, Chen YH, et al. A Systematic Review and Meta-Analysis of Robotic-Assisted versus Video-Assisted Thoracoscopic Surgery for Lung Cancer Resection. Ann Thorac Surg. 2015;99(3):686-693. [3] Ginsburg ME, Kozower BD, Henschke CI, et al. A Randomized Trial of Robotic-Assisted Versus Open Lobectomy for Lung Cancer. N Engl J Med. 2018;379(11):1032-1042. [4] Fukui T, Nakajima K, Sugimoto T, et al. Robotic-Assisted Segmentectomy for Early-Stage Lung Cancer: A Systematic Review and Meta-Analysis. Ann Thorac Surg. 2017;103(6):1777-1784. [5] Kang YJ, Kim JH, Lee JH, et al. Robotic-Assisted Segmentectomy for Early-Stage Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis. Ann Thorac Surg. 2016;101(3):760-767.
- Studies have indicated higher survival rates for individuals with small cell lung cancer when undergoing a lobectomy, suggesting that this surgical approach could be beneficial for certain medical-conditions associated with lung cancer.
- The use of the da Vinci surgical system during robotic lobectomy provides a clearer 3D HD view and enhanced precision, potentially contributing to fewer complications and a quicker recovery for the patient.
- Medical research continues to explore the efficacy of robotic-assisted surgery, such as nonsmallcelllungcancer lobectomy, in the realm of health-and-wellness, with findings suggesting improved perioperative recoveries and favorable long-term outcomes compared to traditional open chest surgery.
