Robotic Surgery for the Thoracic and Vascular Surgeon

Abstract

In the last two decades, robotic-assisted approaches have gained popularity as alternatives to conventional open and minimal-invasive surgery (MIS). The robotic approach combines the concepts of the traditional MIS with the latest technological advancements, enabling the surgeon to control the instrumentation using a robotic device connected to a remote console. With this approach, the surgeon obviates the known drawbacks of conventional MIS, such as the reduced in-depth perception and hand-eye coordination. Since its introduction, numerous robotic-assisted procedures have been developed and tested across nearly all surgical fields. Data from previous studies have shown that a great majority of these techniques are feasible and have favourable treatment outcomes. In the field of thoracic and vascular surgery, two disciplines often combined in Belgium, robotic approaches have been implemented in the treatment of a wide array of disorders including lung cancer, mediastinal tumours, thoracic outlet syndrome, diaphragmatic paralysis, sympathectomy, aortobifemoral bypass surgery and division of the arcuate ligament for median arcuate ligament syndrome (MALS). Despite this increasing popularity, there are still a number of controversies regarding robotic surgery. There are only limited data on the cost-effectiveness of robotic surgery and its objective proven benefit over conventional MIS. In this review, we summarise the latest data on robotic approaches for the most relevant thoracic and vascular disorders.