Robot-assisted thoracic surgery
Topic Status Complete
Robot-assisted thoracic surgery.
Outcome of the appraisal
The evidence does not support the routine adoption of robot-assisted thoracic surgery.
The current evidence suggests equivalent clinical outcomes but uncertainty about any improvement in short and long term clinical effectiveness of robotic thoracic surgery as compared to standard of care (open or video-assisted thoracic surgery).
The economic analysis suggests that robotic thoracic surgery is not cost effective compared to video-assisted thoracic surgery although there is uncertainty around some key aspects of the analysis.
Why was this topic appraised?
Robot-assisted thoracic surgery (RATS) is a form of minimally invasive surgery for people undergoing resection of tissue from the chest cavity, due to cancer or other conditions. Current treatment involves either an open operation or video-assisted thoracoscopic surgery (VATS), which is a different minimally invasive approach using instruments guided by an invasive camera.
This is a reassessment of this technology, following HTW’s first assessment in 2019 (EAR011). Reassessment of the topic was proposed by representatives of South Wales Adult Thoracic Surgical Services, Swansea Bay University Health Board.
Plain language summary
Some people with cancer or other conditions need an operation to remove part, or all, of a diseased lung. Currently, this operation can either be done by opening up the chest wall to get access to the lung or by using instruments that are guided by a tiny camera that goes into the chest through small cuts. Which one is used generally depends on how advanced the disease is. This is called thoracic surgery, or surgery on the organs inside the chest.
Robot-assisted thoracic surgery is also done through one, or a series, of small cuts. The robotic device is controlled by the surgeon. It is used to replace the movements of the surgeon’s own hands and fingers. It is proposed that the operation will be performed with more accuracy on small sections of the lungs that would otherwise be difficult for the surgeon to get to.
Health Technology Wales assessed the use of robot-assisted thoracic surgery to help NHS Wales decide if it should be made available to specialist centres. The evidence does not support the routine adoption of robot-assisted thoracic surgery.
Topic Exploration Report
TER042 07.2019
Evidence Appraisal Report
EAR011-2 10.2023
Guidance
GUI011-2 10.2023
This is an updated version of an appraisal. HTW originally issued Guidance on this topic in September 2019. The Guidance and supporting documents from previous appraisals are available from HTW upon request.
Health Technology Wales Partners
