Robotic lobectomy is the surgical removal of one of the lobes in the lung using the daVinci Surgical System. It can be an effective treatment for people with early stage lung cancer.
Swedish is one of the few centers in the Northwest to offer robotic lobectomy, which helps patients recover from surgery sooner.
In a series of videos that starts with the one below, Dr. Alexander Farivar describes the robotic lobectomy procedure and its benefits.
Robotic lobectomy is done in an operating room with a specially trained support staff.
Patients are under general anesthesia, and constantly monitored by an anesthesiologist.
During the procedure:
- The surgeon makes four small incisions on a patient's side
- A tiny viewing scope and specially designed surgical instruments are inserted through the incisions
- The arms of the daVinci robot are then attached to the instruments
- The surgeon sits at a nearby console, controlling every movement of the robot
- The surgeon carefully separates the affected lobe and pulls it out through one of the small incisions
- The lymph nodes draining the lobe are also removed
Once the procedure is complete, the surgical instruments are removed and the small incisions sutured closed.
Here is an article with video clips of Swedish thoracic surgeons performing a lobectomy that were invited to submit to an international cardiothoracic surgery website.
A lobectomy done robotically is much less invasive than a thoracotomy or sternotomy – the traditional "open" surgeries.
Thoracotomy involves making a long incision on the side of the chest and spreading the ribs. Sternotomy involves making a long incision in the chest, then splitting the breast bone to open the chest.
These procedures are usually necessary for patients with more advanced cancer. But many people with early stage lung cancer are good candidates for robotic lobectomy.
A large incision – along with spreading ribs or opening the chest – causes considerable trauma to the body. Patients who undergo a thoracotomy or sternotomy spend several days in the hospital and take weeks to recover.
With robotic lobectomy, patients typically experience:
- A shorter hospital stay – usually going home about four days after surgery
- Less pain after surgery
- An earlier return to normal activities
Even patients in their 80s – who are often not candidates for open surgery – have good recoveries with robotic lobectomy.
You may have heard about VATS (Visually Assisted Thoracic Surgery) for lung surgery. VATS is also less invasive than open surgery, and also involves operating through small incisions in the chest.
With VATS, surgeons insert rigid-handled instruments through the incisions, and view the surgery on a flat-screen monitor. It is a difficult procedure to perform.
In comparison, robotic surgery uses extremely flexible instruments, which can mimic the movement of the human wrist – without any tremor. This allows surgeons to operate more intuitively.
They also view the surgical area up close through a magnified system that shows everything in three dimensions.
Thoracic surgeons at Swedish – who also pioneered VATS procedures in the Northwest – have found that the advantages of robotic surgery over VATS include:
- The greatly improved surgical instruments
- Significantly better visibility of vital structures, such as pulmonary arteries
- The ability to perform precise movements and dissection more easily
These surgeons recently published their research results comparing robotic surgery with VATS.
All surgeries involve some degree of risk, and discussing this with your doctor is an important part of preparing for any surgery.
Complications from robotic surgery are uncommon. Complications associated with open surgery include bleeding, post-surgical infection, and blood clots in the legs (deep-vein thrombosis).
Robotic surgical systems are now widely available, but few surgeons are currently using them to perform robotic lobectomies. Thoracic robotic surgery, in particular, is a fairly recent advancement – one that requires training, skill and experience to be done properly.
When you interview surgeons you are considering, be sure to ask:
- How much robotic surgery experience do they have?
- How many robotic lobectomies have they performed?
- How long has robotic surgery been available at the hospital?
- How many robotic lobectomies are performed at their hospital?
Swedish is a regional center for performing – and teaching – robotic surgery. More than 4,000 robotic procedures have been performed here and everyone on our robotic surgery teams is specially trained and highly experienced.
The thoracic surgeons teach robotic surgery around the country, and publish in national journals on outcomes after robotic surgery.