Training Cardiothoracic Residents in Robotic Lobectomy Is Cost-Effective With No Change in Clinical Outcomes

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Education

Background:

• Robotic lung resection is an evolving surgical technique.
• The role of trainee participation in robotic procedures requires evaluation.
• Assessing quality and cost-effectiveness is crucial for widespread adoption.

Purpose of the Study:

• To evaluate changes in quality and cost associated with robotic lung resection.
• To assess the impact of significant trainee participation on robotic procedures.
• To compare robotic outcomes with thoracotomy and video-assisted thoracic surgery (VATS).

Main Methods:

• Analysis of 483 anatomic lung resections (robotic, thoracotomy, VATS) from January 2006 to June 2016.
• Comparison of clinical outcomes, costs, and cancer-related data.
• Statistical analysis using propensity scores and Kaplan-Meier survival evaluation.

Main Results:

• Robotic surgery demonstrated the shortest length of stay (3 days) and lower complication rates compared to thoracotomy.
• Stage I non-small cell lung cancer survival rates were comparable across robotic, thoracotomy, and VATS.
• Robotic lung resection was associated with lower hospitalization costs than thoracotomy, with comparable costs to VATS.

Conclusions:

• Robotic lung resection can be safely performed and taught in academic medical centers.
• Trainee participation in robotic lung resection increased significantly over the study period without compromising outcomes.
• The findings support the integration of robotic surgery into surgical training programs.