Current status of minimally invasive surgery for lung cancer

Abstract

The current status of minimally invasive surgery for lung cancer was reviewed according to the literature. Video-assisted thoracic surgery (VATS) is recommended as grade C1 in the latest lung cancer medical guideline and is widely performed in clinical practice. VATS has also been retrospectively reported to be a lessinvasive procedure than thoracotomy and superior with regard to perioperative outcomes. Robot-assisted thoracoscopic surgery (RATS) has also been found attractive and is expected to counter the disadvantages associated with conventional VATS. Regarding VATS and RATS lobectomy for lung cancer, both approaches have been reported to show comparable safety and efficacy, although RATS is superior with regard to maneuverability and the learning curve. However, the high cost and long operative time associated with RATS are of concern. Although experience with RATS is still in the initial phase, the Japanese health insurance system just started to cover RATS for lung cancer in the of spring 2018. RATS is expected to gradually be adopted going forward, subsequently showing improvements in the perioperative outcome. It will be important to verify the efficacy of RATS while still performing VATS for the time being.