Robotic surgery for lung cancer involves using a camera that provides a detailed view of the inside of a person’s chest.
The term “robotic” can be misleading, as it is not a robot that performs the procedure. Instead, a surgeon uses surgical instruments that they guide via a console, meaning that the procedure is robotic-assisted.
Robotic-assisted surgery is much less invasive than open chest surgery, providing various recovery-related benefits. It also has fewer risks.
In this article, we examine robotic-assisted surgery for lung cancer, looking at the procedure and the different types. We also look at the benefits and risks of robotic-assisted surgery.
Robotic-assisted surgery is one of two minimally invasive alternatives to open chest surgery for lung cancer, according to the American Lung Association. The other minimally invasive option is video-assisted thoracoscopic surgery (VATS). Minimally invasive means that a surgeon makes only small cuts when performing surgery.
Robotic-assisted surgery uses computer enhanced robotic technology called the da Vinci surgical system. This system allows a surgeon to operate on the chest area using a 3D high definition camera and tiny rotating instruments. These instruments move in a similar way to a human hand but with a greater range of movement and accuracy.
During robotic-assisted surgery, a surgeon sits at a console and makes small cuts through which the operation takes place. They then insert a camera and miniature surgical instruments into the area of the lung cancer. The console transmits the camera’s 360-degree view of the surgical field.
Holding the console controls, the surgeon makes small hand movements. The system translates these into tiny movements by the surgical instruments inside the lungs. Finally, the surgeon removes lung tissue through one of the cuts along with the surgical instruments.
A doctor will consider a person’s condition and medical history before deciding whether robotic-assisted surgery is a suitable option for them.
A person could be a candidate for this type of surgery if their tumor is close to the outside of the lungs and not attached to blood vessels.
Surgeons may use robotic technology for three types of lung cancer surgery. These include:
- Lobectomy: This term refers to the removal of the entire affected lobe of the lung.
- Wedge resection: This procedure involves the removal of the tumor, along with a small wedge of the healthy lung tissue surrounding it.
- Segmentation: In this procedure, the surgeon removes more tissue than during the wedge resection but less tissue than in the lobectomy.
Research comparing the outcomes of people with small cell lung cancer following the three types of surgery found a link between lobectomy and higher survival rates. Among the participants for whom a lobectomy was not suitable, the outcomes were better with segmentation than with wedge resection.
Lobectomy may result in better outcomes, but not everyone can have this procedure. For example, the authors of one study note that 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.
As robotic-assisted surgery is minimally invasive, it has several benefits. These include:
- a shorter hospital stay
- quicker recovery
- less pain
- fewer complications
- less blood loss
- smaller scars
- no cutting of the breastbone or ribs
Everyone who has robotic-assisted surgery will respond differently. A person’s response will depend on several factors, such as their medical history and the type of lung cancer.
A study in The Annals of Thoracic Surgery compared the effects of robotic lobectomy with those of open chest lobectomy. The researchers found that robotic-assisted surgery led to lower complication rates and shorter hospital stays.
Other research in The Journal of Thoracic and Cardiovascular Surgery looked at the long-term survival rates of people who had robotic lobectomy to treat non-small cell lung cancer. The authors described the 5-year survival rates as promising.
In addition to having benefits over open chest surgery, robotic-assisted surgery may have some advantages over VATS. For instance, it provides the surgeon with a better view and greater accuracy of movement. However, more research is necessary to determine whether the benefits result in better outcomes for patients.
All surgery, even a minimally invasive operation for lung cancer, carries risks, such as:
- air leakage from the lungs
- abnormal heartbeats
The procedure for robotic-assisted surgery typically involves the following steps:
- The person undergoing surgery receives general anesthesia.
- The surgeon inserts a breathing tube into the individual’s airway.
- The surgeon makes one to five small cuts between the person’s ribs.
- The surgeon inserts the camera and surgical instruments between the ribs.
- Once the operation is complete, the surgeon inserts a chest tube through one of the cuts to drain any excess air or fluid.
- The chest tube stays in place for several days, and healthcare professionals will remove it before the person goes home.
Research indicates that robotic lobectomy tends to involve a 4-day stay in the hospital. After a person goes home from the hospital, they usually regain most of their breathing, energy, and strength within 2–3 weeks.
A 2018 study assessed the average cost of robotic-assisted surgery for a lobectomy, finding that this amount ranged from about $15,440 to $22,582.
It helps to know how the cost compares with that of other options. An additional study found that robotic-assisted surgery costs approximately $3,000–$4,500 more than video-assisted surgery.
The study also showed that open chest surgery is more expensive than both robotic-assisted and video-assisted surgery. Reasons for this could include the increased need for intensive care, respiratory therapy, and more prolonged hospitalization with open chest surgery.
Robotic-assisted surgery for lung cancer may offer potential advantages over open chest surgery, including shorter hospital stays and faster recovery times. As with any surgery, robotic-assisted operations have risks.
Robotic-assisted surgery for lung cancer requires a person to stay in the hospital for a few days. Following discharge, most people recover at home within 2–3 weeks.