Robot-assisted thoracoscopic surgery (RATS) or video-assisted thoracoscopic surgery (VATS)?

Surgical support robots developed in the United States in the1990s have rapidly become popular since 2000. As of 2020, more than 5,500 units have been in operation and more than 6 million surgeries have been performed, probably due to da Vinci systems (Intuitive Surgical, co.) being used most around the world. Initially, there were many surgeries in the urology and gynecological areas, but due to the precise field of view of 3D and operability, it is considered to have many advantages in the thoracic surgery area, and the number of cases has increased, making it one of the important options for minimally invasive surgery.

On the other hand, video-assisted thoracoscopic surgery (VATS) began to spread in the 1990s as an alternative to open surgery and has now established itself as a representative surgical method for minimally invasive surgery. In recent years, uniportal VATS has attracted attention and more and more facilities are actively working on it in search of even more minimally invasiveness.

Robot-assisted thoracoscopic surgery (RATS) and uniportal VATS are both surgical methods that represent minimally invasive surgery and have many benefits in the thoracic surgery field, but the former still has limited implementation facilities and high cost issues, the latter of which can be introduced in facilities that have VATS in place, but it is said that it will take time to acquire the technic. In this special feature, we asked five experts in each field to discuss these two minimally invasive surgeries based on their present and future prospects. In any case, we have no doubt that we now have useful minimally invasive surgery option. It would be greatly appreciated if we could contribute even a little to the development of minimally invasive surgery in the future.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Video-Assisted Thoracic Surgery for the series “Robotic VS Uniportal VATS”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/vats-2019-ruv-06). The series “Robotic VS Uniportal VATS” was commissioned by the editorial office without any funding or sponsorship. KY served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Video-Assisted Thoracic Surgery from May 2020 to April 2022. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Kazuo Yoshida