Cardiothoracic Surgery Slow to Adopt Robotic Technology, But Times May Be Changing

Robotic-assisted surgery has grown in popularity among many US surgeons. In fact, urologists and gynecologists use robots for a majority of their procedures. So why are thoracic surgeons still performing traditional open surgery 50% of the time?

Thomas K. Varghese, MD, MS

Thomas K. Varghese, MD, MS

Is it because they believe open surgery is best for their patients? Or are they unable to gain access to the equipment?

“Thoracic surgeons have been late adopters of robotic technology, but industry leaders are getting on board. I think we’re going to make up for lost time,” said Thomas K. Varghese, MD, MS, from the University of Utah School of Medicine in Salt Lake City, who will moderate Tuesday’s panel session featuring four proponents of robotic surgery.

The session will explore innovative techniques, best practices, patient benefits, financial considerations, and training for robotic surgery.

“Today, most cardiothoracic training programs teach all three operating platforms: open thoracic surgery, video-assisted thoracic surgery (VATS), and robotic-assisted thoracic surgery. Trainees who have a complete foundation are considered the best candidates for quality centers,” said Dr. Varghese, who said he believes that almost every high-volume center in the US should have at least one robotic-assisted surgery system in place. 

“We will discuss how to compete with urologists and gynecologists for access and how to negotiate with the C-suite for extra equipment,” he added.

Building a Thoracic Robotics Program

11:00 a.m. – 12:00 p.m.
Room 225

Dr. Varghese said he is perplexed by the lack of support for robotics among some of his colleagues. In his mind, the benefits over open surgery are clear: smaller incisions, no rib-spreading, less pain, shorter hospital stays, and quicker recovery. Robotics simply is the next generation of minimally invasive surgery.

“The robotic incisions are even smaller than VATS. The robotic arms allow wrist-like movements that are far more precise than VATS instruments. And the high-definition, 3D monitors make it much easier to move around arteries, veins, and critical structures,” he said.

Of course, robotic surgery is not right for every patient, nor every surgeon. Naysayers point to a lack of hard evidence about outcomes. “It’s a justified criticism,” said Dr. Varghese. “We need a randomized clinical trial that proves robots are better than VATS.”

Another complaint from hospital administrators is the price tag. Some believe costs will drop when competitive systems enter the marketplace. Many argue that while the initial expenditure is high, the return on investment can be considerable over time.

Both advocates and critics will learn new information about the future of robotics at this session. “We look forward to a robust, open conversation,” said Dr. Varghese. “That’s good for our field and good for our patients.”

Stephanie G. Worrell, MD, from the University Hospitals Cleveland Medical Center in Ohio, will present “Robotics and My First 100 Days in Practice.”

Dr. Worrell added that the session will serve as a great networking opportunity. “I hope to encourage junior faculty about the resources available to help them embark on a thoracic robotics program,” she said.