Dr. Vallieres on Comparing VATS to Robotic Surgery in Lung Cancer

Eric Vallieres, MD, medical director, Division of Thoracic Surgery, Swedish Medical Center, discusses comparisons between video-assisted thoracic surgery (VATS) and robotic surgery in the treatment of patients with lung cancer.

For straightforward lung resections, there are no obvious benefits for robotic thoracic surgery over VATS, Vallieres says. For the surgeons who are still comfortable performing VATS, they are not doing a disservice to patients. Robotic surgery is still video-based, but the surgeon is using a different field of view that offers a more precise way of controlling the instruments inside the chest. Vallieres says the noticeable differences between these modalities might be more apparent with more complex procedures, but this remains to be seen. There have not been randomized studies comparing 1 surgical approach with the other.

In terms of postoperative quality of life, Vallieres notes that what keeps patients in the hospital is not incision size but air leaks and other complications. If a surgeon does an open surgery, VATS, or robotic surgery, the patient’s hospital stay remains the same if they have no air leaks.

There is also the issue of cost. Robotic surgeries are more expensive, but Vallieres suggests that as this approach becomes more universal, the cost will go down. Currently, for a robotic procedure to make sense, it would have to result in 1 less day of hospital stay or less staples being used.