Skip to main content
SpringerLink
Log in

Robotic Surgery in General Thoracic Surgery

  • Chapter
  • First Online:
Robotic Surgery

  • 1793 Accesses

Abstract

Robotic assistance can facilitate minimally invasive surgery (MIS) and has been widely adopted across multiple specialties. This article reviews the published literature on the use of this technology for the treatment of thoracic diseases and describes the robot-assisted thoracoscopic techniques for lung cancer and mediastinal tumors. Although the most common use for robotics has been to treat urologic oncologic conditions, it has also widely started to be adopted for general thoracic surgeries. For early-stage lung cancer treatment, there is evidence that robotics offers short-term benefits, such as shorter lengths of stay (LOS) and decreased postoperative pain, with safety profiles and oncologic outcomes comparable with open or thoracoscopic approaches. However, long-term oncologic outcomes are generally lacking, and robotic surgeries are more costly than open or thoracoscopic surgeries. Therefore, whether the benefits of robotics justify the higher costs warrant large comparative effectiveness studies with long-term outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kwoh YS, Hou J, Jonckheere EA, Hayati S (1988) A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. IEEE Trans Bio Med Eng 35(2):153–160. doi:10.1109/10.1354

    Article  CAS  Google Scholar 

  2. Satava RM (2002) Surgical robotics: the early chronicles—a personal historical perspective. Surg Laparosc Endosc Percutan Tech 12(1):6–16

    Article  PubMed  Google Scholar 

  3. Anderson CA, Hellan M, Falebella A, Lau CS, Grannis FW, Kernstine KH (2007) Robotic-assisted lung resection for malignant disease. Innovations 2(5):254–258. doi:10.1097/IMI.0b013e31815e52f1

    PubMed  Google Scholar 

  4. Ashton RC Jr, Connery CP, Swistel DG, DeRose JJ Jr (2003) Robot-assisted lobectomy. J Thorac Cardiovasc Surg 126(1):292–293

    Article  PubMed  Google Scholar 

  5. Augustin F, Bodner J, Wykypiel H, Schwinghammer C, Schmid T (2011) Initial experience with robotic lung lobectomy: report of two different approaches. Surg Endosc 25(1):108–113. doi:10.1007/s00464-010-1138-3

    Article  PubMed  Google Scholar 

  6. Bodner J, Wykypiel H, Wetscher G, Schmid T (2004) First experiences with the da Vinci™ operating robot in thoracic surgery. Eur J Cardiothorac Surg 25(5):844–851. doi:10.1016/j.ejcts.2004.02.001

    Article  CAS  PubMed  Google Scholar 

  7. Braumann C, Jacobi CA, Menenakos C, Ismail M, Rueckert JC, Mueller JM (2008) Robotic-assisted laparoscopic and thoracoscopic surgery with the da Vinci system: a 4-year experience in a single institution. Surg Laparosc Endosc Percutan Tech 18(3):260–266. doi:10.1097/SLE.0b013e31816f85e5

    Article  PubMed  Google Scholar 

  8. Cerfolio RJ, Bryant AS, Skylizard L, Minnich DJ (2011) Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. J Thorac Cardiovasc Surg 142(4):740–746. doi:10.1016/j.jtcvs.2011.07.022

    Article  PubMed  Google Scholar 

  9. Dylewski MR, Ohaeto AC, Pereira JF (2011) Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg 23(1):36–42. doi:10.1053/j.semtcvs.2011.01.005

    Article  PubMed  Google Scholar 

  10. Gharagozloo F, Margolis M, Tempesta B (2008) Robot-assisted thoracoscopic lobectomy for early-stage lung cancer. Ann Thorac Surg 85(6):1880–1885. doi:10.1016/j.athoracsur.2008.02.085, Discussion 1885-1886

    Article  PubMed  Google Scholar 

  11. Gharagozloo F, Margolis M, Tempesta B, Strother E, Najam F (2009) Robot-assisted lobectomy for early-stage lung cancer: report of 100 consecutive cases. Ann Thorac Surg 88(2):380–384. doi:10.1016/j.athoracsur.2009.04.039

    Article  PubMed  Google Scholar 

  12. Giulianotti PC, Buchs NC, Caravaglios G, Bianco FM (2010) Robot-assisted lung resection: outcomes and technical details. Interact Cardiovasc Thorac Surg 11(4):388–392. doi:10.1510/icvts.2010.239541

    Article  PubMed  Google Scholar 

  13. Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, Caravaglios G (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138(7):777–784. doi:10.1001/archsurg.138.7.777

    Article  PubMed  Google Scholar 

  14. Jang HJ, Lee HS, Park SY, Zo JI (2011) Comparison of the early robot-assisted lobectomy experience to video-assisted thoracic surgery lobectomy for lung cancer: a single-institution case series matching study. Innovations 6(5):305–310. doi:10.1097/IMI.0b013e3182378b4c

    PubMed  Google Scholar 

  15. Kernstine KH, Anderson CA, Falabella A (2008) Robotic lobectomy. Oper Tech Thorac Cardiovasc Surg 13(3):204.e1–204.e23

    Article  Google Scholar 

  16. Melfi FM, Menconi GF, Mariani AM, Angeletti CA (2002) Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg 21(5):864–868

    Article  PubMed  Google Scholar 

  17. Park BJ, Flores RM, Rusch VW (2006) Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results. J Thorac Cardiovasc Surg 131(1):54–59. doi:10.1016/j.jtcvs.2005.07.031

    Article  PubMed  Google Scholar 

  18. Veronesi G, Galetta D, Maisonneuve P, Melfi F, Schmid RA, Borri A, Vannucci F, Spaggiari L (2010) Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg 140(1):19–25. doi:10.1016/j.jtcvs.2009.10.025

    Article  PubMed  Google Scholar 

  19. Mohr FW (2011) Pioneer in cardiac surgery. Circulation 123:f74

    Google Scholar 

  20. Ginsberg RJ, Rubinstein LV (1995) Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung cancer study group. Ann Thorac Surg 60(3):615–622, Discussion 622–613

    Article  CAS  PubMed  Google Scholar 

  21. Swanson SJ, Herndon JE II, D'Amico TA, Demmy TL, McKenna RJ Jr, Green MR, Sugarbaker DJ (2007) Video-assisted thoracic surgery lobectomy: report of CALGB 39802—a prospective, multi-institution feasibility study. J Clin Oncol 25(31):4993–4997

    Article  PubMed  Google Scholar 

  22. Rueth NM, Andrade RS (2010) Is VATS lobectomy better: perioperatively, biologically and oncologically? Ann Thorac Surg 89:S2107–2111. doi:10.1016/j.athoracsur.2010.03.020

    Article  PubMed  Google Scholar 

  23. Farjah F, Wood DE, Mulligan MS, Krishnadasan B, Heagerty PJ, Symons RG, Flum DR (2009) Safety and efficacy of video-assisted versus conventional lung resection for lung cancer. J Thorac Cardiovasc Surg 137(6):1415–1421. doi:10.1016/j.jtcvs.2008.11.035

    Article  PubMed  Google Scholar 

  24. Flores RM, Alam N (2008) Video-assisted thoracic surgery lobectomy (VATS), open thoracotomy, and the robot for lung cancer. Ann Thorac Surg 85(2):S710–715. doi:10.1016/j.athoracsur.2007.09.055

    Article  PubMed  Google Scholar 

  25. Grogan EL, Jones DR (2008) VATS lobectomy is better than open thoracotomy: what is the evidence for short-term outcomes? Thorac Surg Clin 18(3):249–258. doi:10.1016/j.thorsurg.2008.04.007

    Article  PubMed  Google Scholar 

  26. Petersen RP, Pham D, Burfeind WR, Hanish SI, Toloza EM, Harpole DH Jr, D'Amico TA (2007) Thoracoscopic lobectomy facilitates the delivery of chemotherapy after resection for lung cancer. Ann Thorac Surg 83(4):1245–1249. doi:10.1016/j.athoracsur.2006.12.029, Discussion 1250

    Article  PubMed  Google Scholar 

  27. Whitson BA, D'Cunha J, Andrade RS, Kelly RF, Groth SS, Wu B, Miller JS, Kratzke RA, Maddaus MA (2008) Thoracoscopic versus thoracotomy approaches to lobectomy: differential impairment of cellular immunity. Ann Thorac Surg 86(6):1735–1744. doi:10.1016/j.athoracsur.2008.07.001

    Article  PubMed  Google Scholar 

  28. Yan TD, Black D, Bannon PG, McCaughan BC (2009) Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol 27(15):2553–2562. doi:10.1200/JCO.2008.18.2733

    Article  PubMed  Google Scholar 

  29. Boffa DJ, Allen MS, Grab JD, Gaissert HA, Harpole DH, Wright CD (2008) Data from the society of thoracic surgeons general thoracic surgery database: the surgical management of primary lung tumors. J Thorac Cardiovasc Surg 135(2):247–254. doi:10.1016/j.jtcvs.2007.07.060

    Article  PubMed  Google Scholar 

  30. Cao C, Manganas C, Ang SC, Yan TD (2012) A systematic review and meta-analysis on pulmonary resections by robotic video-assisted thoracic surgery. Ann Cardiothorac Surg 1(1):3–10. doi:10.3978/j.issn.2225-319X.2012.04.03

    PubMed Central  PubMed  Google Scholar 

  31. Lee HS, Jang HJ (2012) Thoracoscopic mediastinal lymph node dissection for lung cancer. Semin Thorac Cardiovasc Surg 24(2):131–141. doi:10.1053/j.semtcvs.2012.02.004

    Article  PubMed  Google Scholar 

  32. Darling GE, Allen MS, Decker PA, Ballman K, Malthaner RA, Inculet RI, Jones DR, McKenna RJ, Landreneau RJ, Rusch VW (2011) Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American college of surgery oncology group Z0030 trial. J Thorac Cardiovasc Surg 141(3):662–670. doi:10.1016/j.jtcvs.2010.11.008

    Article  PubMed  Google Scholar 

  33. Izbicki J, Thetter O, Habekost M, Karg O, Passlick B, Kubuschok B, Busch C, Haeussinger K, Knoefel W, Pantel K (2005) Radical systematic mediastinal lymphadenectomy in non‐small cell lung cancer: a randomized controlled trial. Br J Surg 81(2):229–235

    Article  Google Scholar 

  34. Keller SM, Adak S, Wagner H, Johnson DH (2000) Mediastinal lymph node dissection improves survival in patients with stages II and IIIa non-small cell lung cancer. Eastern cooperative oncology group. Ann Thorac Surg 70(2):358–365, Discussion 365–356

    Article  CAS  PubMed  Google Scholar 

  35. Park JS, Kim K, Choi MS, Chang SW, Han WS (2011) Video-assisted thoracic surgery (VATS) lobectomy for pathologic stage I non-small cell lung cancer: a comparative study with thoracotomy lobectomy. Korean J Thorac Cardiovasc Surg 44(1):32–38. doi:10.5090/kjtcs.2011.44.1.32

    Article  PubMed Central  PubMed  Google Scholar 

  36. Sagawa M, Sato M, Sakurada A, Matsumura Y, Endo C, Handa M, Kondo T (2002) A prospective trial of systematic nodal dissection for lung cancer by video-assisted thoracic surgery: can it be perfect? Ann Thorac Surg 73(3):900–904

    Article  PubMed  Google Scholar 

  37. Watanabe A, Koyanagi T, Ohsawa H, Mawatari T, Nakashima S, Takahashi N, Sato H, Abe T (2005) Systematic node dissection by VATS is not inferior to that through an open thoracotomy: a comparative clinicopathologic retrospective study. Surgery 138(3):510–517

    Article  PubMed  Google Scholar 

  38. Park BJ, Melfi F, Mussi A, Maisonneuve P, Spaggiari L, Da Silva RK, Veronesi G (2012) Robotic lobectomy for non-small cell lung cancer (NSCLC): long-term oncologic results. J Thorac Cardiovasc Surg 143(2):383–389. doi:10.1016/j.jtcvs.2011.10.055

    Article  PubMed  Google Scholar 

  39. Park BJ (2012) Robotic lobectomy for non-small cell lung cancer (NSCLC): multi-center registry study of long-term oncologic results. Ann Cardiothorac Surg 1(1):24–26. doi:10.3978/j.issn2225-319X.2012.04

    PubMed Central  PubMed  Google Scholar 

  40. Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, Postmus PE, Rusch V, Sobin L, International Association for the Study of Lung Cancer International Staging C, Participating I (2007) The IASLC lung cancer staging project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol: Official Publication of the International Association for the Study of Lung Cancer 2(8):706–714. doi:10.1097/JTO.0b013e31812f3c1a

    Article  Google Scholar 

  41. Toker A, Sonett J, Zielinski M, Rea F, Tomulescu V, Detterbeck FC (2011) Standard terms, definitions, and policies for minimally invasive resection of thymoma. J Thorac Oncol 6(7 Suppl 3):S1739–1742. doi:10.1097/JTO.0b013e31821ea553

    Article  PubMed  Google Scholar 

  42. Marulli G, Rea F, Melfi F, Schmid TA, Ismail M, Fanucchi O, Augustin F, Swierzy M, Di Chiara F, Mussi A, Rueckert JC (2012) Robot-aided thoracoscopic thymectomy for early-stage thymoma: a multicenter European study. J Thorac Cardiovasc Surg 144(5):1125–1130. doi:10.1016/j.jtcvs.2012.07.082

    Article  PubMed  Google Scholar 

  43. Toker A, Erus S, Ozkan B, Ziyade S, Tanju S (2011) Does a relationship exist between the number of thoracoscopic thymectomies performed and the learning curve for thoracoscopic resection of thymoma in patients with myasthenia gravis? Interact Cardiovasc Thorac Surg 12(2):152–155. doi:10.1510/icvts.2010.254599, Epub 2010 Nov 9

    Article  PubMed  Google Scholar 

  44. McKenna RJ Jr (2008) Complications and learning curves for video-assisted thoracic surgery lobectomy. Thorac Surg Clin 18(3):275–280. doi:10.1016/j.thorsurg.2008.04.004

    Article  PubMed  Google Scholar 

  45. Park BJ, Flores RM (2008) Cost comparison of robotic, video-assisted thoracic surgery and thoracotomy approaches to pulmonary lobectomy. Thorac Surg Clin 18(3):297–300. doi:10.1016/j.thorsurg.2008.05.003, vii

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

I would like to send a great thanks to my mentor, Dr. Jae Ill Zo for always being in my corner with great support. And, I appreciate all my patients and colleagues for my robotic surgeries.

Author information

Authors and Affiliations

  1. Department of Systems Biology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, 7435 Fannin Street, 2SCR3 3205, Houston, TX, USA, 77054

    Hyun-Sung Lee M.D., Ph.D. & Hee-Jin Jang M.D.

Authors
  1. Hyun-Sung Lee M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hee-Jin Jang M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hyun-Sung Lee M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Ishikawa, Japan

    Go Watanabe

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Japan

About this chapter

Cite this chapter

Lee, HS., Jang, HJ. (2014). Robotic Surgery in General Thoracic Surgery. In: Watanabe, G. (eds) Robotic Surgery. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54853-9_11

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-54853-9_11

  • Published:

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54852-2

  • Online ISBN: 978-4-431-54853-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation