A community hospital's experience with robotic thoracic surgery

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Minimally invasive thoracic surgery improves postoperative recovery.
• Robotic-assisted thoracoscopic surgery (RATS) offers advanced visualization and ergonomics compared to video-assisted thoracoscopic surgery (VATS).
• RATS has demonstrated comparable short- and long-term outcomes to VATS.

Purpose of the Study:

• To define the learning curve associated with robotic-assisted thoracoscopic surgery (RATS).

Main Methods:

• Retrospective review of a single surgeon's RATS experience (December 2011 - April 2014).
• Patients were divided into "early" (pre-February 2013) and "late" (post-February 2013) groups.
• Statistical analysis included Fisher's exact t test and paired t test, with significance set at P < 0.05.

Main Results:

• No statistical significance in conversion rates (13% vs 10%) or operative time (180 vs 204 min) between early and late groups.
• Postoperative morbidity (21% vs 28%) and mortality (3% vs 0%) were equivalent between groups.
• A higher percentage of lobectomies were performed in the late group (65% vs 38%), with faster execution.

Conclusions:

• Surgeon experience with RATS correlates with increased operative complexity.
• The learning curve for RATS does not negatively impact postoperative morbidity or mortality.
• RATS allows for the performance of more complex procedures as surgeon proficiency grows.