Lung Surgery

Learn about lung surgery and understand your options

It can be hard to open up

When you’re facing lung cancer, it can be hard to open up and talk about your diagnosis with family and friends. A lung cancer diagnosis may be upsetting for you and everyone who loves you. It’s also the second most common cancer in men and women who live in the U.S.1 In 2019, it’s expected that doctors will diagnose more than 228,000 new lung cancer cases in the U.S.1—that’s almost a quarter of a million people who, like you, want to learn about their disease and understand their options.

The first thing to know is that there are three types of lung cancer. About 85 percent of lung cancers are non-small cell lung cancer, which includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Small cell lung cancer makes up about 10 to 15 percent of lung cancer diagnoses, and lung carcinoid tumors make up less than 5 percent of lung cancers.2

Understanding your options

How doctors address lung cancer depends on the type of lung cancer you have, whether it has spread to nearby lymph nodes or beyond, and your age and overall health. Depending on those factors, doctors may recommend surgery, chemotherapy, targeted therapy, immunotherapy, radiofrequency ablation (a small electric probe inserted into the tumor is heated to destroy it), radiation therapy, or a combination of these options.3-5

Doctors may recommend surgery for lung cancer, especially if the cancer has been identified early.6-8 To understand the type of surgery your doctor recommends, it’s important to know that your lungs are separated into sections called lobes with airway tubes called bronchus running through them. Your doctor may recommend wedge resection surgery or segmentectomy to remove part of one lobe, a lobectomy to remove an entire lobe, or a pneumonectomy to remove all of either your right or left lung.

Surgeons can perform lung surgery through open surgery or a minimally invasive approach. Traditional open surgery requires the surgeon to make a long incision between your ribs and then spread your ribs apart so that the surgeon can see and work on your lung.

There are two minimally invasive approaches for lung surgery: video-assisted thoracoscopic surgery (VATS) or robotic-assisted surgery, possibly with da Vinci® technology. Both minimally invasive surgical options require a few small incisions and do not require spreading apart of the ribs. Through the small incisions, doctors insert surgical equipment and a camera for viewing the surgical area. In video-assisted surgery, doctors use special long-handled tools to perform surgery while viewing magnified images from the videoscope (camera) on a video screen.

How da Vinci works

Surgeon hands on davinci system controlsSurgeons using da Vinci technology may be able to perform certain types of lung surgery (lobectomy, segmentectomy, and wedge resection) through a few small incisions (cuts). During surgery, your surgeon sits at a console next to you and operates using tiny, wristed instruments.

 
A camera provides a high-definition, 3D magnified view inside your body. The da Vinci system translates every hand movement your surgeon makes in real time to bend and rotate the instruments with precision.

 

It’s important to remember that Intuitive does not provide medical advice. After discussing all options with your doctor, only you and your doctor can determine whether surgery with da Vinci is appropriate for your situation. You should always ask your surgeon about his or her training, experience, and patient outcomes.

More about da Vinci

Why surgery with da Vinci?

A review of published studies suggests that potential benefits of lobectomy (lobe removal) surgery with da Vinci technology include:

  • Patients may experience fewer complications after surgery, though sometimes a similar amount, compared to patients who had open surgery.9-13
  • Patients may experience similar complication rates compared to patients who had video-assisted thoracic surgery.9,13-21
  • Patients may stay in the hospital for a shorter amount of time, though sometimes similar, than patients who had open9-11,13,22-27 or video-assisted thoracic surgery.9,13-23,25-35
  • Surgeons may be as likely, or possibly less likely, to switch to open surgery compared to video-assisted thoracic surgery.14-16,18-20,26

All surgery involves risk. You can read more about associated risks of lobectomy here

 

Questions you can ask your doctor

  • What medical and surgical options are available for me?
  • Which is best for my situation?
  • What are the differences between open, video-assisted thoracic surgery, and robotic-assisted surgery?
  • If you suggest I have lung cancer surgery, how can I prepare for it?
    Can you tell me about your training, experience, and patient outcomes with da Vinci?

Find a da Vinci surgeon

Resources for learning more

Lung surgery brochure

Take away information about lung surgery with da Vinci technology in our brochure designed for patients and their families.

About your options

Thoracic surgery with da Vinci

Robotic-assisted surgery with da Vinci technology is used in many different types of procedures by thoracic surgeons.

About the specialty


  1. Key Statistics for Lung Cancer. American Cancer Society. Web. 24 January 2019 
  2. Lung Cancer. American Cancer Society. Web. 24 January 2019 
  3. Treating Non-Small Cell Lung Cancer. American Cancer Society. Web. 24 January 2019 h
  4. Treating Small Cell Lung Cancer. American Cancer Society. Web. 24 January 2019 
  5. Treating Lung Carcinoid Tumors. American Cancer Society. Web. 24 January 2019 
  6. Surgery for Non-Small Cell Lung Cancer. American Cancer Society. Web 24 January 2019 
  7. Surgery for Small Cell Lung Cancer. American Cancer Society. Web. 24 January 2019 
  8. Surgery to Treat Lung Carcinoid Tumors. American Cancer Society. Web. 24 January 2019 
  9. Kent, M., T. Wang, et al., Open, Video-Assisted Thoracic Surgery, and Robotic Lobectomy: Review of a National Database. Ann Thorac Surg, 2014.
  10. Veronesi, G.G., P. Maisonneuve, et al., Four-arm robotic lobectomy for the treatment of early-stage lung cancer. Journal of Thoracic and Cardiovascular Surgery, 2010. 140(1): p. 19-25.
  11. Oh, D.S., I. Cho, et al., Early adoption of robotic pulmonary lobectomy: feasibility and initial outcomes. Am Surg, 2013. 79(10): p. 1075-80.
  12. Zhang, L. and S. Gao, Robot-assisted thoracic surgery versus open thoracic surgery for lung cancer: a system review and meta-analysis. Int J Clin Exp Med 2015. 8(10): p. 17804-17810
  13. Deen, S.A., J.L. Wilson, et al., Defining the Cost of Care for Lobectomy and Segmentectomy: A Comparison of Open, Video-Assisted Thoracoscopic, and Robotic Approaches. Ann Thorac Surg, 2014.
  14. Augustin, F., J. Bodner, et al., Robotic-assisted minimally invasive vs. thoracoscopic lung lobectomy: comparison of perioperative results in a learning curve setting. Langenbecks Arch Surg, 2013.
  15. Jang, H.J.L., H. S.; Park, S. Y.; Zo, J. I., Comparison of the early robot-assisted lobectomy experience to video-assisted thoracic surgery lobectomy for lung cancer: A single-institution case series matching study. Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, 2011. 6(5): p. 305-310.
  16. Mahieu, J., P. Rinieri, et al., Robot-Assisted Thoracoscopic Surgery versus Video-Assisted Thoracoscopic Surgery for Lung Lobectomy: Can a Robotic Approach Improve Short-Term Outcomes and Operative Safety? Thoracic and Cardiovascular Surgeon, 2015.
  17. Paul, S., J. Jalbert, et al., Comparative Effectiveness of Robotic-Assisted vs. Thoracoscopic Lobectomy. Chest, 2014. 146(6): p. 1505-12
  18. Liang, H., W. Liang, et al., Robotic Versus Video-assisted Lobectomy/Segmentectomy for Lung Cancer: A Meta-analysis. Ann Surg., 2017 Jun 16 [Epub ahead of print]
  19. Wei, S., M. Chen, et al., Feasibility and safety of robot-assisted thoracic surgery for lung lobectomy in patients with non-small cell lung cancer: a systematic review and meta-analysis. World J Surg Oncol., 2017. 15(1):98
  20. Yu, Z., Q. Xie, et al., Perioperative outcomes of robotic surgery for the treatment of lung cancer compared to a conventional video-assisted thoracoscopic surgery (VATS) technique. Oncotarget., 2017. 8(53): p. 91076-91084
  21. Swanson, S.J., D.L. Miller, et al., Comparing robot-assisted thoracic surgical lobectomy with conventional video-assisted thoracic surgical lobectomy and wedge resection: Results from a multihospital database (Premier). Journal of Thoracic and Cardiovascular Surgery, 2013.
  22. Adams, R.D., W.D. Bolton, et al., Initial Multicenter Community Robotic Lobectomy Experience: Comparisons to a National Database. Ann Thorac Surg, 2014.
  23. Farivar, A.S., R.J. Cerfolio, et al., Comparing Robotic Lung Resection With Thoracotomy and Video-Assisted Thoracoscopic Surgery Cases Entered Into The Society of Thoracic Surgeons Database. Innovations (Phila), 2014. 9(1): p. 10-5.
  24. Cerfolio, R.J., A.S. Bryant, et al., Initial consecutive experience of completely portal robotic pulmonary resection with 4 arms. Journal of Thoracic and Cardiovascular Surgery, 2011.
  25. Rajaram, R., S. Mohanty, et al., Nationwide Assessment of Robotic Lobectomy for Non-Small Cell Lung Cancer. Ann Thorac Surg, 2017. 103(4): p. 1092-1100
  26. Yang, C-F.J., Z. Sun, et al., Use and Outcomes of Minimally Invasive Lobectomy for Stage I Non-Small Cell Lung Cancer in the National Cancer Data Base. Ann Thorac Surg, 2016. 101(3): p. 1037–42
  27. Agzarian, J., C. Fahim, et al. The Use of Robotic-Assisted Thoracic Surgery for Lung Resection: A Comprehensive Systematic Review. Semin Thorac Cardiovasc Surg,  2016. 28(1): p. 182-92
  28. Bodner, J., T. Schmid, et al., Minimally invasive approaches for lung lobectomy - From VATS to robotic and back! European Surgery - Acta Chirurgica Austriaca, 2011. 43(4): p. 224-228.
  29. Lee, B.E., R.J. Korst, et al., Transitioning from video-assisted thoracic surgical lobectomy to robotics for lung cancer: Are there outcomes advantages? J Thorac Cardiovasc Surg, 2013.
  30. Lee, B.E., M. Shapiro, et al., Nodal Upstaging in Robotic and Video Assisted Thoracic Surgery Lobectomy for Clinical N0 LungCancer. Annals of Thoracic Surgery, 2015.
  31. Louie, B.E.F., A. S.; Aye, R. W.; Vallieres, E., Early Experience With Robotic Lung Resection Results in Similar Operative Outcomes and Morbidity When Compared With Matched Video-Assisted Thoracoscopic Surgery Cases. Annals of Thoracic Surgery, 2012.
  32. Spillane, J. and P. Brooks, Developing a robotic program in thoracic surgery at Cape Cod Hospital. Journal of Robotic Surgery, 2014: p. 1-8.
  33. Emmert, A., C. Straube, et al., Robotic versus thoracoscopic lung resection: A systematic review and meta-analysis. Medicine, 2017. 96(35):e7633
  34. Louie, B.E., J. Wilson, et al., Comparison of Video-Assisted Thoracoscopic Surgery and Robotic Approaches for Clinical Stage I and Stage II Non-Small Cell Lung Cancer Using The Society of Thoracic Surgeons Database. Ann Thorac Surg., 2016. 102(3): p. 917-924
  35. Lee, H.S.J., H. J., Thoracoscopic mediastinal lymph node dissection for lung cancer. Semin Thorac Cardiovasc Surg, 2012. 24(2): p. 131-41.

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Important Safety Information

Patients should talk to their doctors to decide if da Vinci® surgery is right for them. Patients and doctors should review all available information on nonsurgical and surgical options and associated risks in order to make an informed decision. 

Serious complications may occur in any surgery, including da Vinci surgery, up to and including death. Serious risks include, but are not limited to, injury to tissues and organs and conversion to other surgical techniques, which could result in a longer operative time and/or increased complications. For Important Safety Information, including surgical risks, indications, and considerations and contraindications for use, please also refer to www.intuitive.com/safety.

Individuals' outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics, and/or surgeon experience.

Product names are trademarks or registered trademarks of Intuitive Surgical, or of their respective holders.

©2019 Intuitive Surgical, Inc. All rights reserved. Product names are trademarks or registered trademarks of their respective holders. The information on this website is intended for a United States audience only.


 

Website Disclaimer for intuitivesurgical.com and davincisurgery.com

This website does not provide medical advice. If you think you have a medical emergency, call your doctor or 911 immediately.

The materials on this website are for general educational information only. Information you read on this website cannot replace the relationship that you have with your healthcare professional. Intuitive Surgical does not practice medicine or provide medical services or advice and the information on this website should not be considered medical advice. You should always talk to your healthcare provider for diagnosis and treatment. Health information changes quickly. Therefore, it is always best to consult with your healthcare provider.

If you have questions about the da Vinci® Surgical System or about surgical procedures conducted with the da Vinci Surgical System, consult a surgeon that has experience with the da Vinci Surgical System. A list of surgeons that have experience with the da Vinci Surgical System can be found in the Surgeon Locator.

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