Robotic thoracic surgery—fewer ports and eagerly awaited new platforms
Editorial

Robotic thoracic surgery—fewer ports and eagerly awaited new platforms

Since the introduction of robotics in thoracic surgery in the early 20th century (1), the application of the da Vinci platform has been further extended to address different pathologies within in the chest.

Over the past years various approaches have been described for lung resections [for example with CO2 (2) or without CO2 (3)], for resection of mediastinal tumors (especially thymectomy) as well as for other pathologies (i.e., sympathectomy, first rib resection, etc.).

With the gradual further development of the robotic platform, also these techniques have been adapted continuously in order to take advantage of the new features of the da Vinci platform such as for example the thinner trocars (8 mm), that allowed for a reduction of access port size and access ports in general (4).

In this special series we aim to highlight some of the established techniques, but also some of the ‘newer’ approaches with less trocars and smaller incisions.

As for anatomic lung resections, similar to the situation in video-assisted thoracic surgery, the trend clearly goes towards two or only one access ports. Furthermore, the approval of different robotic platforms is expected to open a whole new field of single-incision access techniques in robotic surgery.


Acknowledgments

Funding: None.


Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Visualized Surgery for the series “Robotic Thoracic Surgery: Established Procedures & Current Trends”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://jovs.amegroups.com/article/view/10.21037/jovs-24-12/coif). The series “Robotic Thoracic Surgery: Established Procedures & Current Trends” was commissioned by the editorial office without any funding or sponsorship. G.J.K. served as the unpaid Guest Editor of the series and serves as an unpaid Associate Editor-in-Chief of Journal of Visualized Surgery from March 2024 to February 2026. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.


References

  1. Melfi FM, Menconi GF, Mariani AM, et al. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg 2002;21:864-8. [Crossref] [PubMed]
  2. Cerfolio RJ, Bryant AS, Minnich DJ. Starting a robotic program in general thoracic surgery: why, how, and lessons learned. Ann Thorac Surg 2011;91:1729-36; discussion 1736-7. [Crossref] [PubMed]
  3. Veronesi G, Galetta D, Maisonneuve P, et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg 2010;140:19-25. [Crossref] [PubMed]
  4. Manolache V, Motas N, Bosinceanu ML, et al. Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience. Ann Cardiothorac Surg 2023;12:102-9. [Crossref] [PubMed]
Gregor J. Kocher

Gregor J. Kocher1,2,3, MD, MBA (IHM)

1Department of Thoracic Surgery, Hirslanden Clinic Beau Site, Bern, Switzerland;2Department of Thoracic Surgery, Lindenhof Hospital, Bern, Switzerland;3Department of Thoracic Surgery, St. Clara Hospital, Basel, Switzerland.
(Email: gregor.kocher@hin.ch)

Keywords: Robotic thoracic surgery; lung cancer; port placement; multiport robot-assisted thoracic surgery (multiport RATS); uniportal RATS

Received: 11 June 2024; Accepted: 24 June 2024; Published online: 23 July 2024.

doi: 10.21037/jovs-24-12

doi: 10.21037/jovs-24-12
Cite this article as: Kocher GJ. Robotic thoracic surgery—fewer ports and eagerly awaited new platforms. J Vis Surg 2024;10:15.

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