Acceptance of minimally invasive surgery as a whole will dictate the future of robotic surgery
Minimally invasive surgery (MIS) for thoracic diseases has proven advantages including decreased postoperative pain and hospital length of stay when compared to thoracotomy, and multiple studies provide data to suggest that MIS is oncologically equivalent to thoracotomy for the treatment of early stage lung cancer. Despite the evidence, thoracotomy remains the more commonly performed procedure with video-assisted thoracic surgery (VATS) being performed in about 30% of lobectomies (1-4). The question remains as to whether robotic or VATS is a superior approach to lobectomy for non-small cell lung cancer (NSCLC). This topic has also been the focus of many previous studies which reveal no clear-cut differences between the two in regards to post-operative outcomes (4-9). What makes the study by Yang et al. unique, is the use of propensity matching to differentiate between robotic, VATS, and open approaches to lobectomy (10). More specifically, this is a retrospective review of prospectively collected data from a single institution, Memorial Sloan-Kettering Cancer Center, comparing overall survival, disease-free survival, and perioperative outcomes among propensity matched patients with clinical stage I NSCLC who underwent lobectomy via either robotic surgery, VATS, or thoracotomy.