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Updated: Feb 28, 2026
Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
Published on: April 19, 2024
Thymectomy via open surgery or robotic video assisted thoracic surgery: Can a recommendation already be made?
Judith Buentzel1, Carmen Straube, Judith Heinz
1Department of Haematology and Oncology Department of Medical Statistics Department of General, Visceral and Pediatric Surgery, University of Goettingen, University Medical Center Goettingen, Goettingen Westklinikum Hamburg, Department of General and Visceral Surgery, Hamburg Department of Thoracic and Cardiovascular Surgery, University of Goettingen, University Medical Center Goettingen, Göttingen, Germany.
Background:
Robot-assisted minimally invasive surgery (RVATS) is a relatively new technique applied for thymectomies. Only few studies directly compare RVATS to the mainstay therapy, open surgery (sternotomy).
Methods:
A systematic search of the literature was performed in October 2016. The meta-analysis includes studies comparing robotassisted and open thymectomy regarding operation time, length of hospitalization, intraoperative blood loss, and chest-in-tube days, postoperative complications, reoperation, arrhythmic events, pleural effusion, and postoperative bleeding.
Results:
Of 626 studies preliminary screened, 7 articles were included. There were no significant differences in comparison of operation time (-3.19 minutes [95% confidence interval, 95% CI -112.43 to 106.05]; P = .94), but patients undergoing RVATS spent significantly less time in hospital (-4.06 days [95% CI -7.98 to -0.13], P = .046). There were fewer chests-in-tube days (-2.50 days [95% CI -15.01 to 10.01]; P = .24) and less intraoperative blood loss (-256.84 mL [95% CI -627.47 to 113.80]; P = .10) observed in the RVATS group; due to a small number of studies, these results were not statistically significant. There were also less post-operative complications in the RVATS group (12 complications in 209 patients vs 51 complications in 259 patients); however, this difference was not statistical significant (odds ratio 0.27, 95% CI 0.07-1.12; P = .06).
Conclusions:
Patients undergoing RVATS spent less time in hospital than patients treated by open surgery (sternotomy). These patients tended to have less postoperative complications, less intraoperative blood loss, and fewer chest-in-tube days. We found evidence for the safety and feasibility of RVATS compared with open surgery, which has to be further confirmed in randomised controlled trials.
