Robotic Surgery for Lung Cancer

This information is useful for adults
A woman thinks about her robotic surgery for lung cancer

The term “robotic surgery” may conjure up an image of a human-sized robot wielding a scalpel—a picture that would make anyone cringe. The reality is quite different. Surgical robots are nothing like humans; rather, they are an increasingly common tool in the hands of highly skilled surgeons, and allow for better precision than other types of surgeries.

Robotic surgery is not new. But while urologists and gynecologic surgeons have been using it successfully for decades, its use for lung cancer surgeries is more recent. “We’re now developing robotic lung surgery to be the standard of care for how we manage our patients,” says Justin Blasberg, MD, the director of robotic thoracic surgery for Yale Medicine. “We’ve become very skilled in managing malignancies of the chest with the robot, and we think it offers significant advantages for our patients.” 

Surgery is the first line of treatment for (and can be enough to cure patients who have) localized non-small cell lung tumors that have not spread (or metastasized) to other parts of the body. Non-small cell lung cancer is one of two primary types of lung cancer (named for how the cancer cells look under a microscope). Surgery is rarely used for the other primary type, called small cell lung cancer, which can metastasize early and extensively, becoming inoperable.

There are two general approaches to lung cancer surgery:

Open surgery: A thoracotomy involves making incisions on the back and the chest following the curves of the ribs, then dividing muscles of the chest wall and spreading the ribs with a retractor to access the lung.

Minimally invasive surgery: Thoracoscopy (also known as video-assisted thoracoscopic surgery, or VATS) involves the surgeon inserting tiny instruments and a camera through small incisions in the chest, with guidance from images on a video screen. Robotic surgery is also a minimally invasive surgery, but it uses robotic arms to perform the operation through those same small incisions in the chest. 

The amount of tissue the surgeon removes depends on such factors as the type of lung cancer, as well as its size and position, and whether it has spread. The surgeon may recommend the following:

Lobectomy: This removes an entire lobe that has been affected by cancer. There are three lobes on the right lung and two on the left. Each one has the same function—to bring oxygen to the bloodstream and remove carbon dioxide. Lobectomy is the most common and preferred method for treating for non-small cell lung cancer.

Segmental resection: This removes part of a lobe.

Sleeve lobectomy: When lung cancer is found in the large airways of the lung, the surgeon cuts out the diseased area and then sews together the remaining parts. This may include removing one of more lobes to remove all disease.   

Wedge resection: Removal of a part of a section of lung that includes part of one or more lobes.

Pneumonectomy: An entire lung is removed.