Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review

For over two decades, robotic-assisted thoracic surgery (RATS) has revolutionized thoracic oncology. With enhanced visualization, dexterity, and precision, RATS has reduced blood loss, shortened hospital stays, and sped up recovery compared to traditional surgery or video-assisted thoracoscopic surg...

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Main Authors: Giacomo Cusumano, Giuseppe Calabrese, Filippo Tommaso Gallina, Francesco Facciolo, Pierluigi Novellis, Giulia Veronesi, Stefano Viscardi, Filippo Lococo, Elisa Meacci, Alberto Terminella, Gaetano Romano, Cristina Zirafa, Franca Melfi, Stefano Margaritora, Marco Chiappetta
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/5/244
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author Giacomo Cusumano
Giuseppe Calabrese
Filippo Tommaso Gallina
Francesco Facciolo
Pierluigi Novellis
Giulia Veronesi
Stefano Viscardi
Filippo Lococo
Elisa Meacci
Alberto Terminella
Gaetano Romano
Cristina Zirafa
Franca Melfi
Stefano Margaritora
Marco Chiappetta
author_facet Giacomo Cusumano
Giuseppe Calabrese
Filippo Tommaso Gallina
Francesco Facciolo
Pierluigi Novellis
Giulia Veronesi
Stefano Viscardi
Filippo Lococo
Elisa Meacci
Alberto Terminella
Gaetano Romano
Cristina Zirafa
Franca Melfi
Stefano Margaritora
Marco Chiappetta
author_sort Giacomo Cusumano
collection DOAJ
description For over two decades, robotic-assisted thoracic surgery (RATS) has revolutionized thoracic oncology. With enhanced visualization, dexterity, and precision, RATS has reduced blood loss, shortened hospital stays, and sped up recovery compared to traditional surgery or video-assisted thoracoscopic surgery (VATS). The use of 3D high-definition imaging and articulated instruments allows for complex resections and advanced lymph node assessment. RATS delivers oncological outcomes similar to open surgery and VATS, with high rates of complete (R0) resections and acceptable complication rates. Its minimally invasive nature promotes quicker recovery. Advances in imaging software and augmented reality further enhance surgical accuracy and reduce intraoperative risks. However, RATS has some limitations, including high costs and a lack of tactile feedback, and certain complex procedures, such as extended resections and intrapericardial interventions, remain challenging. With growing experience and technological advances, RATS shows promise in reducing morbidity, improving quality of life, and expanding access to advanced oncologic care. This article reviews the evolution, benefits, and limitations of RATS in NSCLC treatment, highlighting its emerging role in managing complex cases.
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series Current Oncology
spelling doaj-art-b7765f24f8e747408fc5205262f951be2025-08-20T02:33:31ZengMDPI AGCurrent Oncology1198-00521718-77292025-04-0132524410.3390/curroncol32050244Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative ReviewGiacomo Cusumano0Giuseppe Calabrese1Filippo Tommaso Gallina2Francesco Facciolo3Pierluigi Novellis4Giulia Veronesi5Stefano Viscardi6Filippo Lococo7Elisa Meacci8Alberto Terminella9Gaetano Romano10Cristina Zirafa11Franca Melfi12Stefano Margaritora13Marco Chiappetta14General Thoracic Surgery Unit, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, 95100 Catania, ItalyThoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyDepartment of Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalySchool of Medicine, Vita-Salute San Raffaele University, 20123 Milano, ItalySchool of Medicine, Vita-Salute San Raffaele University, 20123 Milano, ItalySchool of Medicine, Vita-Salute San Raffaele University, 20123 Milano, ItalyThoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyThoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyGeneral Thoracic Surgery Unit, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, 95100 Catania, ItalyMinimally Invasive and Robotic Thoracic Surgery, University Hospital of Pisa, 56124 Pisa, ItalyMinimally Invasive and Robotic Thoracic Surgery, University Hospital of Pisa, 56124 Pisa, ItalyDepartment of Pharmacy, Health and Nutrition Sciences, University of Calabria (UniCal), 87036 Rende, ItalyThoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyThoracic Surgery, Magna Graecia University, 88100 Catanzaro, ItalyFor over two decades, robotic-assisted thoracic surgery (RATS) has revolutionized thoracic oncology. With enhanced visualization, dexterity, and precision, RATS has reduced blood loss, shortened hospital stays, and sped up recovery compared to traditional surgery or video-assisted thoracoscopic surgery (VATS). The use of 3D high-definition imaging and articulated instruments allows for complex resections and advanced lymph node assessment. RATS delivers oncological outcomes similar to open surgery and VATS, with high rates of complete (R0) resections and acceptable complication rates. Its minimally invasive nature promotes quicker recovery. Advances in imaging software and augmented reality further enhance surgical accuracy and reduce intraoperative risks. However, RATS has some limitations, including high costs and a lack of tactile feedback, and certain complex procedures, such as extended resections and intrapericardial interventions, remain challenging. With growing experience and technological advances, RATS shows promise in reducing morbidity, improving quality of life, and expanding access to advanced oncologic care. This article reviews the evolution, benefits, and limitations of RATS in NSCLC treatment, highlighting its emerging role in managing complex cases.https://www.mdpi.com/1718-7729/32/5/244non-small cell lung cancerrobotic surgeryRATSmini-invasive surgery
spellingShingle Giacomo Cusumano
Giuseppe Calabrese
Filippo Tommaso Gallina
Francesco Facciolo
Pierluigi Novellis
Giulia Veronesi
Stefano Viscardi
Filippo Lococo
Elisa Meacci
Alberto Terminella
Gaetano Romano
Cristina Zirafa
Franca Melfi
Stefano Margaritora
Marco Chiappetta
Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review
Current Oncology
non-small cell lung cancer
robotic surgery
RATS
mini-invasive surgery
title Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review
title_full Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review
title_fullStr Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review
title_full_unstemmed Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review
title_short Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review
title_sort technical innovations and complex cases in robotic surgery for lung cancer a narrative review
topic non-small cell lung cancer
robotic surgery
RATS
mini-invasive surgery
url https://www.mdpi.com/1718-7729/32/5/244
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