Robot- vs Video-Assisted Thoracoscopic Lobectomy for Early Lung Cancer

Abstract

Robot-assisted thoracoscopic surgery (RATS) is increasingly considered an alternative to video-assisted thoracoscopic surgery (VATS) and thoracotomy for patients with resectable nonsmall cell lung cancer (NSCLC). RATS has several potential advantages compared with VATS, including increased intraoperative rotational capacity, three-dimensional visualization, a shorter hospitalization, and improved postoperative analgesia, although these have not been demonstrated uniformly or in prospective, randomized trials (1-3). However, RATS has been associated with increased costs, and early reports revealed a potentially increased risk of cardiovascular complications compared with VATS (4,5). Further, the comparative oncologic effectiveness of RATS compared with VATS has not been demonstrated in prospective trials, although single institution and registry analyses have demonstrated similar survival in patients undergoing lobectomy with either approach (6,7).