Robotic-Assisted Approaches to Chest Wall Resection: Considerations and Operative Techniques

Although data are lacking, the authors believe robotic-assisted thoracoscopic chest wall resection is safe and oncologically effective and might be associated with decreased postoperative pain and morbidity compared with traditional open techniques. The criteria for robotic thoracoscopic resection are similar to those used for video-assisted thoracoscopic surgery-guided resection with the exception that a robotic approach is feasible even for superior sulcus and first rib-based lesions. A totally robotic or hybrid approach may be used, with the latter including an incision over the chest wall lesion to enable rib division and extraction following thoracoscopic mobilization.