Development of a robot-assisted thoracic surgery (RATS) program. Lessons learned after 2500 cases

Area of Science:

• Minimally Invasive Surgery
• Thoracic Surgery
• Surgical Robotics

Background:

• Robotic surgery offers enhanced visualization, instrument dexterity, and ergonomics.
• Adoption in thoracic surgery has lagged compared to other specialties.
• Robotic-assisted thoracic surgery (RATS) presents unique implementation challenges.

Purpose of the Study:

• To describe institutional experience with RATS from 2012-2020.
• To analyze program growth, common procedures, and outcomes.
• To identify critical factors for successful RATS program development.

Main Methods:

• Retrospective review of RATS procedures performed between 2012 and 2020.
• Analysis of annual program growth, procedure types, surgical times, and length of stay.
• Evaluation of factors contributing to program success and financial outcomes.

Main Results:

• The RATS program demonstrated an average annual growth of 55%.
• Lobectomies, wedge resections, and segmentectomies were the most frequent procedures.
• Surgical time and length of stay decreased with increasing procedural volume, indicating a learning curve effect.

Conclusions:

• Successful RATS implementation relies on adequate resources, strong leadership, team motivation, and structured training.
• Data collection and analysis are crucial for continuous improvement and cost reduction.
• RATS can lead to improved financial outcomes and reduced costs in thoracic surgery.