Robotic vs. video-assisted thoracoscopic surgery: a retrospective analysis of safety and length of stay during initial implementation of a robotic program.

BACKGROUND

There is ongoing equipoise regarding the use of robotics in the field of thoracic surgery. This study compares the safety and length of stay (LOS) outcomes of robotic-assisted thoracoscopic surgery (RATS) with the current standard of care, video-assisted thoracoscopic surgery (VATS), during the initial adoption phase of RATS at a Canadian tertiary care thoracic surgery center.

METHODS

We retrospectively reviewed lung and mediastinal resections performed via RATS or VATS from 2022 to 2024. Data were extracted from the institutional electronic medical record. Multiple linear regression was performed to assess the impact of surgical approach on LOS, adjusting for relevant covariates. Adverse event rates were compared using Chi-squared tests.

RESULTS

A total of 119 RATS and 390 VATS lung resections were analyzed. Median LOS was 3 days [interquartile range (IQR): 1-5 days] for RATS and 2 days (IQR: 1-5 days) for VATS, with no significant difference. Adverse event rates were 29% (35/119) in the RATS group and 39% (153/390) in the VATS group. For mediastinal resections, 41 RATS and 19 VATS cases were included. Median LOS was significantly shorter for RATS [1 day (IQR: 1-2 days)] compared to VATS [2 days (IQR: 2-5 days)] (P<0.05). Adverse event rates were comparable [29% (12/41) for RATS and 26% (5/19) for VATS].

CONCLUSIONS

During the early implementation phase of RATS, outcomes were comparable to the established VATS program with respect to safety and LOS. Notably, RATS was associated with a shorter LOS for mediastinal resections.