The state of the art and future directions of robotic-assisted thoracic surgery

Video-assisted thoracic surgery (VATS) has been widely adopted in early-stage lung cancer as an oncologically sound and minimally invasive approach with certain proven short-term advantages over open thoracotomy especially in terms of postoperative morbidity. Nevertheless, VATS is associated with visual and mechanical limitations, many of which were overcome with the introduction of robotic surgical techniques. Robotic-assisted thoracic surgery (RATS) can approximate the visual perspective of open surgery, while utilizing instruments that mimic the maneuverability of the human wrist and provide magnified three-dimensional imaging. The added cost in addition to the effort required of surgeons to master RATS may be ultimately compensated by enhanced surgical efficiency, access to rapidly developing technical innovations, and the potential for improved patient outcomes.