Robotic lobectomy for lung cancer: initial experience of a single institution in Korea

Background: Robotic surgery is known to have several advantages including magnified three-dimensional vision and angulation of the surgical instruments. To evaluate the feasibility and efficiency of robotic lobectomy in the treatment of lung cancer, we analyzed the outcomes of our initial experiences with robotic lobectomy at a single institution in Korea. Methods: Eighty-seven patients with lung cancer underwent robotic lobectomy (robotic group: 34 patients) and video-assisted thoracic surgery (VATS) lobectomy (VATS group: 53 patients) between 2011 and 2016 at our hospital. The medical records of these patients were retrospectively analyzed. Results: The operation times of the two groups were significantly different (robotic group, 293 +/- 74 min; VATS group, 201 +/- 62 min; P<0.01). Intraoperative blood loss occurred more in the robotic group than in the VATS group (robotic group, 403 +/- 197 mL; VATS group, 298 +/- 188 mL; P=0.018). The numbers of lymph nodes dissected in the two groups were significantly different (robotic group, 22 +/- 12; VATS group, 14 +/- 7; P<0.01). There was no intraoperative mortality in both groups. Conclusions: Despite the initial difficulties, robotic lobectomy for lung cancer was a safe and feasible procedure with no operative mortality. If operation time and intraoperative blood loss improve as the learning curve progresses, robotic surgery may overcome the limitations of VATS in lung cancer surgery.