Thoracic surgery is done on the chest, but it does not involve surgery on the heart. With robot-assisted thoracic procedures, the doctor guides small robotic arms through keyhole incisions.
Keyhole incisions and specialized equipment are used for a robot-assisted thoracic procedure.
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Robot-assisted thoracic procedures are considered for surgeries that: Require precisionDo not require open access
Some thoracic surgeries that have been successfully performed using robotic techniques include: Thymectomy—removal of the thymus gland
Lobectomy—removal of a lung lobe
Esophagectomy—removal of the esophagus
Mediastinal tumor resection—removal of tumors located in the mediastinum, which is the part of the chest cavity that separates the lungs
Sympathectomy—cauterizing a portion of the sympathetic nerve
Compared to more traditional procedures, robotic-assisted surgery may result in: Less scarringReduced recovery timesLess risk of infectionLess blood loss
to the body
Shorter hospital stayFaster recovery
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: BleedingInfectionCollection of air or gases in the lung cavityCollapsed lungNeed for a prolonged artificial respiration on a breathing machineDamage to nearby organs or structures
The need to switch to traditional surgical methods such as
or open surgery
Anesthesia-related problemsNerve damage
Some factors that may increase the risk of complications include: Increased ageObesitySmokingDiabetesExcessive alcohol intakeUse of certain medications
Be sure to discuss these risks with your doctor before the procedure.
Depending on the reason for your surgery, your doctor may do the following: Physical examBlood tests and urine testsChest x-rayPulmonary function testUpper GI seriesElectrocardiogram (EKG)
UltrasoundCT scanMRI scanUpper endoscopy
Leading up to the procedure:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
Take antibiotics if instructed.Follow a special diet if instructed.Shower the night before using antibacterial soap if instructed.Arrange for someone to drive you home from the hospital. Also, have someone to help you at home.Eat a light meal the night before. Do not eat or drink anything after midnight.
will be used. It will block any pain and keep you asleep through the surgery.
You will be connected to a ventilator. This is a machine that moves air in and out of your lungs. Next, several keyhole openings will be cut in the chest wall between the ribs. One or more chest tubes may be placed into the side of the chest. These tubes will be used to drain fluid and monitor air leakage. A needle may be used to inject carbon dioxide gas into the chest cavity. The gas will make it easier for internal structures to be viewed.
A small camera, called an endoscope, will be passed through one of the incisions. The camera will light, magnify, and project the structures onto a video screen. The camera will be attached to one of the robotic arms. The other arms will hold instruments for grasping, cutting, dissecting, and suturing. These may include: ForcepsScissorsDissectorsScalpels
While sitting at a console near the operating table, the doctor will use lenses to look at magnified 3D images of the inside of the body. Another doctor will stay by the table to adjust the camera and tools. The robotic arms and tools will be guided by movements of the surgeon to remove organs and tissue. After the tools are removed, the doctor will use sutures or staples to close the surgical area.
If you are doing well, the breathing tube will be removed. Later, the chest tubes will be removed.
About 1-4 hours, depending on the procedure
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications. You may also feel discomfort from the gas used during the procedure. This can last up to 3 days.
This procedure is done in a hospital setting. The usual length of stay is a few days. Your doctor may choose to keep you longer if you have any problems.
While you are recovering at the hospital, you may receive the following care: Assistance sitting up and moving around soon after surgeryInstructions on what you should eat and how to restrict your activityNutrition through an IV or feeding tube in the days after surgery; you will gradually progress from a liquid to a solid dietDirections on how to do deep breathing and coughing exercises
When you return home, do the following to help ensure a smooth recovery: Limit certain activities, such as doing strenuous exercise, until you have recovered.Participate in any physical therapy or rehabilitation.Follow your doctor's instructions.
Depending on the procedure, you should recover within a few weeks.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor: Cough
or shortness of breath
Coughing up yellow, green, or bloody mucusNew chest painSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from an incision sitePain and/or swelling in your feet, calves, or legsNew or worsening symptoms
If you think you have an emergency, call for medical help right away.
Rea F, Marulli G, et al. Robotic video-assisted thoracoscopic thymectomy.
Multimed Man Cardiothorac Surg. 2005.
Sympathectomy. New York Presbyterian Hospital website. Available at:
http://nyp.org/testsprocedures/showDocument.php?contentTypeId=135&contentId=25&heading=Sympathectomy. Accessed February 19, 2016.
What is robotic surgery? The Robotic Surgery Center at NYU Langone Medical Center website. Available at: http://robotic-surgery.med.nyu.edu/for-patients/what-robotic-surgery. Accessed February 19, 2016.
Last reviewed February 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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