Transitioning to robotics in a successful thoracoscopic and laparoscopic thoracic program: why do it, and how?

The robotic platform has been successfully embraced within thoracic surgery for over 20 years, with numerous applications in both the thoracoscopic as well as the laparoscopic realms. Despite the success of robotic-assisted surgery in a wide range of operations, from lobectomies to benign foregut surgery to esophagectomies, many centers still face significant barriers to the successful implementation of this platform. In this review, we will briefly discuss the applications of the robotic platform within the field of thoracic surgery. We will highlight the advantages of adopting a robotic practice; namely, improved visualization, wristed instruments, ambidexterity, enhanced trainee education, and the potential for better outcomes, such as reduced length of stay and more effective lymphadenectomy. We will emphasize the importance of embracing the robotic platform in the field of thoracic surgery, and we will also address the obstacles that may hinder the adoption of this platform. Finally, we offer potential methods to enhance the transition to a robotic practice in an academic center, and we share our own experience of transitioning to a robotic thoracic practice at the University of Pittsburgh Medical Center (UPMC). With the right approach, we believe this platform can considerably enhance the practice of minimally invasive thoracic surgeons everywhere in the present day.