Robot-Assisted Thoracic Surgery for Lung Cancer in Juntendo University -Safety and benefit

As of 2017, robotic surgery accounted for less than 1% of lung cancer operations. The adoption of robotic surgery for lung cancer has rapidly increased, now comprising over 15% of such procedures. Juntendo University initiated robotic thoracic surgery in 2017 and currently performs approximately 250 robotic surgeries annually, including 150 for lung cancer. While robotic surgery offers advantages such as a three-dimensional field of view and enhanced dexterity through multi-jointed instruments, managing intraoperative complications-particularly bleeding-has been considered a limitation. To address these challenges, our hospital has implemented optimized operating room layouts, conducted emergency thoracotomy simulations, and developed safe surgical protocols. In recent years, the precision of robotic systems has enabled minimally invasive approaches to complex procedures. We have successfully performed advanced surgeries using robotic or robot-assisted techniques, including bronchoplasty, pulmonary artery reconstruction, deep lymph node dissection, and operations involving severe adhesions that are typically difficult with conventional minimally invasive methods. With continued advancements in robotic surgery, a growing number of patients are expected to benefit from minimally invasive treatment options.