Superiorities of robotic segmentectomy: a review

Abstract

Abstract: Several approaches to the resection of lung cancer are now available within the armamentarium of the thoracic surgeon. Robotic-assisted surgery has emerged as a comparable alternative to both the open and video-assisted thoracoscopic (VATS) approaches. Numerous studies have confirmed equivalent oncologic outcomes and superior postoperative outcomes with robotic resections compared to both the open and VATS approaches. In particular, due to the meticulous anatomical dissection required during segmentectomy, there is heightened interest in outcomes research comparing the 3 approaches. The aim of this review is to study the available data on robotic vs. VATS and open segmentectomy and present a thorough comparative analysis including oncologic, postoperative and patient outcomes for and against robotic segmentectomy. In our review, we find robotic segmentectomies to be cost effective and offer improved dexterity resulting in decreased complications and hospital length of stay (LOS). There is promise for this approach especially within the elderly frail patients, and data suggest that the reduction in LOS offsets the higher cost of establishing a robotic program. Ultimately, long-term outcomes from well-designed prospective studied are needed but initial results are promising and have set the acquisition of robotic programs in motion.