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Robotic Surgery Improving Lung Cancer Outcomes

March 27, 2015

Lung cancer is the second most common form of cancer in the U.S., according to the American Cancer Society.

It accounts for 13 percent of all new cancer cases, and this year more than 220,000 people will be diagnosed with the disease.

These numbers are startling, but we’ve made significant progress in how we treat lung cancer. For patients with enough healthy lung tissue, surgery typically has been the most viable option. Lung surgery can involve removal of either the entire lung, a whole section of the lung or a smaller sub-section.

Traditionally, these surgeries have been performed using an open approach, such as an open thoracotomy in which the rib cage is spread. This can lead to a lengthy hospital stay and significant recovery time, with a higher degree of complication than newer methods. Thankfully, more surgeons are slowly starting to adopt minimally invasive techniques.

Minimally Invasive Surgery for Lung Cancer

In recent years, we’ve made significant progress in implementing less-invasive methods of lung cancer surgery. These techniques include video-assisted thoracic surgery (VATS) and robotic surgery.

VATS allows us to view the inside of the chest cavity after we make a small incision and insert a camera attached to a scope. We can examine the lungs and the chest for any abnormalities and take a biopsy, which helps us determine a diagnosis. We also can use this approach to perform minimally invasive lung surgery.

During robotic surgery, we make small incisions to insert microsurgical tools and a high-definition camera into the area where we will operate. We then use a surgical console to view a magnified image of the surgical area and manipulate the robotic controls to perform precise maneuvers within the body.

Benefits of VATS and Robotic Surgery

These minimally invasive procedures have clear benefits. Patients who undergo these surgeries have lower mortality, less pain, fewer complications and a faster recovery compared to open surgical approaches.

VATS and robotic surgery also allow us to have more visibility into the area where we will operate and better control of surgical instruments. Using these approaches, we now can treat more complex cases that typically were done using open procedures with a higher risk of complications.

Programs experienced in robotic lobectomy, a minimally invasive procedure that involves the removal of a section of the lungs, can achieve low mortality rates, minimal blood loss and hospital stays of only two to three days. Our program has a high success rate, and we perform more than 80 percent of our lung cancer operations robotically.

Why Isn’t Minimally Invasive Surgery the Standard?

Despite the great outcomes using minimally invasive techniques, 2010 data indicates that 57 percent of lung cancer surgeries in the U.S. are still performed using open techniques, while 40 percent use the VATS approach and 3.4 percent are done robotically.

This may be because it’s challenging for many doctors to complete a VATS lobectomy efficiently and safely. Robotic lung surgery also requires a deep commitment to a practice dedicated to lung surgery, which is a steep learning curve. And as with anything in life, change is difficult. Unfortunately, there’s still reluctance to transition away from well established open techniques.

Though some people with lung cancer may not be appropriate candidates for these newer procedures, many patients are unaware of the potential benefits of less-invasive techniques for lung cancer surgery. As doctors, we all need to do a better job of explaining every possible treatment option to patients.

We still have a long way to go in getting more doctors to adopt these surgical approaches, but I’m encouraged by the medical advancements we’ve made so far. VATS and robotic surgery provide more treatment options for people with lung cancer and more hope that they can overcome this disease.