BRIEF RESEARCH REPORT article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1647273
This article is part of the Research TopicPersonalized Medicine in Early-Stage Lung Cancer: The Role and Future of Robotic-Assisted TechniquesView all 4 articles
Transitioning from Video-Assisted to Robotic-Assisted Anatomical Pulmonary Resection: Outcomes from 340 Cases in an Australian Centre
Provisionally accepted
Daniel Shell1*
Mohd Firdaus1Natcha Bunwatcharaphan1
Jacob Gordon1Manoras Chengalath1
Cheng-hon Yap1,2,3- 1Barwon Health, Geelong, Australia
- 2Monash University, Melbourne, Australia
- 3Deakin University, Melbourne, Australia
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Background Robotic-assisted thoracoscopic surgery (RATS) is emerging as a technically advanced alternative to video-assisted thoracoscopic surgery (VATS) for anatomical pulmonary resection. While potential benefits include enhanced visualisation and precision, real-world outcome data remain limited— particularly within the Australian healthcare setting. This study evaluates short-term clinical and oncologic outcomes during the transition from VATS to RATS in a single-centre thoracic surgery practice. Methods We conducted a retrospective cohort study of 340 consecutive thoracoscopic anatomical lung resections (segmentectomy, lobectomy, or pneumonectomy) performed by a single surgeon between July 2012 and February 2025 in Geelong, Australia. Short-term outcomes from the first 170 patients treated with RATS during the surgeon's initial robotic experience were compared with a historical cohort of 170 VATS patients. Results Baseline demographics were similar, although the RATS group included a higher proportion of obese patients and segmentectomies. Both groups demonstrated low complication and mortality rates. RATS was associated with significantly higher lymph node yield (11 vs 8 nodes, p<0.001) and shorter postoperative pleural drainage duration (2.2 vs 3.8 days, p<0.001). Hospital length of stay was reduced by more than two days in the RATS group (4.4 vs 6.4 days, p<0.001). Operative time and rates of conversion, upstaging, and readmission were comparable between groups. Conclusion RATS was safely introduced without increased operative time or complication rates and was associated with improved lymphadenectomy and enhanced postoperative recovery. As the largest Australian comparison of RATS and VATS to date, these findings support the integration of robotic pulmonary resection into standard thoracic surgical practice.
Keywords: Thoracic Surgery, thoracic oncology, Rats, VATS, Lobectomy, segmentectomy
Received: 15 Jun 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Shell, Firdaus, Bunwatcharaphan, Gordon, Chengalath and Yap. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daniel Shell, Barwon Health, Geelong, Australia
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