Robot-assisted thoracic surgery

Topic Status Incomplete

Robot-assisted thoracic surgery.

Outcome of the appraisal


Robot-assisted thoracic surgery shows promise for lung resection, but there is currently insufficient evidence to support routine adoption.


The current evidence indicates that robot-assisted thoracic surgery may improve some short-term outcomes compared with conventional surgical approaches but long-term benefits are uncertain. Robot-assisted thoracic surgery is more costly than other types of surgery.


Further research is needed to define the possible impact of robot-assisted surgery on long term survival and disease recurrence as well as on patient experience and post-operative recovery.

Why was this topic appraised?


Robot-assisted thoracic surgery is a form of minimally invasive surgery for people undergoing resection of lung tissue for cancer or other conditions. Current treatment involves either an open operation or a different minimally invasive approach that uses instruments guided by an invasive camera (video-assisted thoracoscopic surgery). The potential advantages of robot-assisted surgery are that it might improve surgical precision as well as offer less invasive surgery and wider removal of diseased tissues.


Plain language summary


Health Technology Wales assessed the use of surgery that uses robotic technology to remove diseased lung tissue to help NHS Wales decide if it should be made available to specialist centres.


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. This means that the operation can be performed with more accuracy on small sections of the lungs that would otherwise be difficult for the surgeon to get to.


HTW’s Guidance currently does not support routine adoption of robot-assisted thoracic surgery as while it shows promise, there is a lack of evidence about its long term effects.  Further research is need on the long-term impacts and on patient experience.

Topic Exploration Report

TER042 07.2019

Evidence Appraisal Review

EAR011 09.2019


GUI010 09.2019

This guidance is currently undergoing reassessment.

Access our guidance

Our advice documents are free to download, but we would be grateful if you could help us improve our services by telling us why you are looking at our advice and how you intend to use it.

  • We may like to contact you by email to find out more about how you used the documents.

  • This field is for validation purposes and should be left unchanged.