Related Experiment Video
Updated: Jan 27, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Postoperative pain after lobectomy: robot-assisted, video-assisted and open thoracic surgery
Augustinus P T van der Ploeg1, Ninos Ayez2, George P Akkersdijk3
1Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands. Ploega@maasstadziekenhuis.nl.
Abstract:
Surgical resection is the optimal procedure for early stage non-small cell lung cancer (NSCLC). Open thoracotomy, video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) are different surgical modalities with possible different outcomes. The aim of this study was to analyze differences in outcome with a focus on postoperative pain. Patients undergoing lobectomy at the Maasstad Hospital in 2015 and 2016 were included. Postoperative pain was scored according to the Numerical Rating Scale (NRS). Additionally, duration of chest tube drainage and thoracic epidural analgesia (TEA), hospital length of stay and type of surgery were assessed. Lobectomy was performed in 57 patients. There was no significant difference in type of surgery, age, gender, right-sided surgery, postoperative NRS scores, duration of chest tube drainage and epidural anesthesia, and hospital length of stay (p > 0.05). Operative time for RATS was significantly longer (p = 0.002). Postoperative pain scores and other outcomes did not differ between the three different modalities in surgery for NSCLC. In the future, more minimally invasive surgery will be used in pulmonary surgery with thoracotomy as a safe alternative in selected cases. Future studies have to demonstrate if RATS will overcome the differences concerning cost-effectiveness over VATS.
Related Concept Videos
Matrix-Assisted Laser Desorption Ionization (MALDI)
Thoracic Aorta
The Thoracic Cage: Sternum
The sternum is the elongated bony structure on the anterior side of the thoracic cage. It consists of three parts: the manubrium, the body, and the xiphoid...
The Thoracic Cage: Ribs
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...
Pain
Pressure Relationships in Thoracic Cavity
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs...

