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Updated: Aug 5, 2026
05:39
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Analgesia in Minimally Invasive Thoracic Surgery: A Comparison Between Robotic Surgery and Video-Assisted
Lucía Valencia1,2,3, Sara Castillo-Acosta4, Ángel Becerra-Bolaños1,3,5
1Department of Anaesthesiology and Intensive Care, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain.
Medicina (Kaunas, Lithuania)
|July 28, 2026
Summary
Robot-assisted thoracic surgery (RATS) showed no superiority over video-assisted thoracoscopic surgery (VATS) for postoperative pain or clinical outcomes. Both minimally invasive techniques offer comparable results in patient recovery and safety.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Surgery
- Surgical Robotics
Background:
- Robot-assisted thoracic surgery (RATS) is increasingly adopted alongside video-assisted thoracoscopic surgery (VATS).
- Comparative evaluation of RATS and VATS is crucial for understanding postoperative pain and clinical outcomes.
- This study addresses the need for evidence-based comparison between these minimally invasive thoracic surgery approaches.
Purpose of the Study:
- To compare acute postoperative pain within 24 hours between RATS and VATS.
- To evaluate differences in postoperative complications, 30-day mortality, and hospital/ICU length of stay.
- To assess patient satisfaction and analgesic requirements following RATS versus VATS procedures.
Main Methods:
- A retrospective observational study included 148 patients undergoing VATS or RATS between November 2021 and December 2024.
- Data on pain (Numeric Rating Scale, subjective assessment, rescue analgesia), complications, mortality, and length of stay were collected.
- Statistical analysis, including multivariable adjustment, was performed to compare outcomes between the two surgical approaches.
Main Results:
- Surgical duration was significantly longer for RATS (218 min) compared to VATS (130 min).
- No significant differences were found in Numeric Rating Scale scores or subjective pain assessment between RATS and VATS.
- While RATS initially showed reduced need for rescue analgesia, this was not statistically significant after adjustment. No significant differences in complications or 30-day mortality were observed. ICU length of stay was longer in the RATS group.
Conclusions:
- Robot-assisted thoracic surgery (RATS) does not demonstrate superiority over video-assisted thoracoscopic surgery (VATS) regarding postoperative pain.
- Clinical outcomes, including complications and patient satisfaction, were comparable between RATS and VATS.
- While RATS may have specific benefits, it did not outperform VATS in the evaluated acute postoperative recovery parameters.