Robotic Surgery for Lung Cancer

Robotic Wedge Resections, Sub-Lobar Resections, and Lobectomies

NYU Langone Medical Center is a national leader in robot-assisted surgery for resectable lung cancer. Our thoracic surgeons are currently performing several different robotic procedures for State 1 and Stage 2 lung cancer, as well as for selected “neoadjuvant” cases, in which the malignancy has already been treated with chemotherapy or radiation and is now considered a good candidate for surgical removal.

In robotic lung cancer surgery, the surgeons operate through small incisions in the chest to remove the tumor and a certain amount of surrounding healthy tissue from the affected lobe. (The right lung is made up three lobes, while the left lung is made up of two.) Our robotic thoracic surgeons perform several different types of lung cancer procedures, depending on the size and location of the tumor.

In a robotic wedge resection, the surgeon removes a small, wedge-shaped portion of lung, including the tumor and a certain amount of healthy tissue around it.

In a robotic sub-lobar resection, the surgeon removes a portion of the anatomic segment that has the tumor in it, as well as some normal surrounding lung.

In a robotic lobectomy, the surgeon removes the entire affected lobe.(i.e., the right upper lobe)

In all three of these procedures, a robotic lymph node dissection (surgical removal of the nearby lymph nodes around the lung and mediastinum) is also performed in order to evaluate whether the cancer has progressed beyond the lungs.

In addition to the above procedures, our surgeons will also perform robotic biopsies of suspicious lung nodules, to assess whether they are malignant or benign.

Advantages of Robotic Lung Cancer Surgery

Our robotic lung surgery program is a natural outgrowth of our surgeons’ pioneering work with the minimally-invasive thoracic surgical technique known as VATS (video-assisted thoracic surgery) for treating lung cancer. Like VATS, robotic lung cancer surgery is performed through a series of small incisions—resulting in a faster recovery and significantly less post-operative discomfort and scarring than traditional open lung cancer surgery, which requires a large incision and use of a mechanical rib spreader.

While both approaches are minimally invasive, robotic surgery offers certain advantages over the VATS approach for lung cancer surgery: Its exceptional precision and highly maneuverable “wrists,” which can rotate through 540 degrees, are ideally suited for resecting lung tissues and dissecting lymph nodes in the confined space of the chest. Another advantage is the da Vinci Si surgical robot’s high-definition, 3-D camera, which provides a superior view of the tissues being operated on. Robotic lung surgery also enables the surgeon to view the lung structures from the front of the chest wall—an approach that more closely resembles that of open surgery. Patients tend to be discharged somewhat sooner following robotic surgery, as well—typically in two to three days, compared to four days for the typical VATS procedure.

Robotic Lung Cancer Surgery at NYU Langone

The NYU Robotic Surgery Center is one of the few institutions in the country to offer a full range of robot-assisted lung cancer procedures, including robotic lobectomies. Our robotic thoracic surgical team includes Dr. Harvey Pass, Chief of Thoracic Surgery at NYU Langone Medical Center and a long-time leader in the development and teaching of minimally-invasive techniques for thoracic surgery, and Dr. Michael Zervos, recently named Director of Robotic Thoracic Surgery at NYU Langone, who is one of a small group of surgeons at NYU Langone and in the U.S. to have performed a large number of lung resections. In recognition of his expertise, Dr. Zervos has been asked by Intuitive, Inc., manufacturer of the da Vinci Si surgical robot, to serve as a proctor for other physicians who are training to perform robot-assisted lung cancer surgery. Dr Costas Bizekis will also be performing robotic lung resections going forward.

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