Robot-assisted thoracic surgery
Topic Status Complete
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.
This guidance was considered for reassessment in December 2021. Following stakeholder consultation and an updated literature search, our Assessment Group concluded that the current evidence is unlikely to change existing recommendations and so not to progress with reassessment at this time.
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
Guidance
GUI010 09.2019
This guidance is currently undergoing reassessment.
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