Open, Video-Assisted Thoracic Surgery, and Robotic Lobectomy: Review of a National Database

Robotic Surgery for Thoracic Disease

“…2) State inpatient databases (SID) showed that 40% of lung cancers were operated on by VATS and 3.4% by robotic systems in 2010. 3) According to the Japanese Association for Thoracic Surgery annual report, 62.9% of total lung cancer surgeries in 2012 were carried out by VATS, 4) but only a few cases by robotic surgery. This infrequency of robotic surgery may be due to different payment systems and the delayed introduction of this system.…”

New era of “resection of the carina and lower trachea”

“…Based on these studies, RATS may become a better option than VATS for trachea surgery. However, there are still some disadvantages of RATS, including higher hospital costs, loss of haptic feedback, longer set-up times, and concern regarding the management of accidental intraoperative bleeding (24,25). Additionally, there are only limited number of reports on the utilization of RATS for airway surgery compared to VATS and conventional thoracotomy surgery.…”

Systematic Review of Published Studies on Safety and Efficacy of Thoracoscopic and Robot-Assisted Lobectomy for Lung Cancer

“…Therefore, at present, the merits of robot-assisted surgery have not yet been verifi ed. Recently, Kent, et al 60) showed similar perioperative outcomes of both thoracoscopic and robot-assisted surgery using large scale of national database in USA. Veronessi, et al 61) summarized the current state, including thoracotomy, whereby the curability and safety of robot-assisted surgery for lung cancer are equivalent and the operability and length of the learning curve are superior to thoracoscopic surgery, but a high cost, limited devices, and a long operative time are disadvantageous.…”

“…Only a few comparative studies are available. [57][58][59][60] At present, only data on short-term results can be compared. When Jang, et al 57) compared 40 patients treated with robotassisted lobectomy for lung cancer and 40 treated with early thoracoscopic surgery, postoperative complications occurred in 4 (10%) and 13 (32.5%) patients, respectively, the intraoperative blood losses were 219 and 374 ml, respectively, and the postoperative length of hospital stay were 6 and 9 days, respectively, showing that the outcome of robot-assisted surgery was signifi cantly more favorable than that of thoracoscopic surgery.…”