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Nishimura et al. Mini-invasive Surg 2020;4:11 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.48

Review Open Access

Robotic lobectomy costs and quality of life

Jennifer M. Nishimura, Matthew Goodwin, Peter Kneuertz, Susan Moffatt-Bruce, Robert E. Merritt,
Desmond M. D’Souza
Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210,
USA.
Correspondence to: Dr. Desmond M. D’Souza, Division of Thoracic Surgery, The Ohio State University Wexner Medical Center,
N835 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA. E-mail: desmond.d’souza@osumc.edu

How to cite this article: Nishimura JM, Goodwin M, Kneuertz P, Moffatt-Bruce S, Merritt RE, D’Souza DM. Robotic lobectomy
costs and quality of life. Mini-invasive Surg 2020;4:11. http://dx.doi.org/10.20517/2574-1225.2019.48

Received: 31 Oct 2019 First Decision: 2 Jan 2020 Revised: 13 Jan 2020 Accepted: 3 Feb 2020 Published: 14 Feb 2020
Science Editor: Valérie Lacroix Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract

The surgical approach for lobectomy has changed over time with recent data demonstrating that the majority are
performed using a minimally invasive approach. While the use of the robotic platform for pulmonary resection has
been shown to have acceptable clinical outcomes, cost and quality of life need to be considered when starting a
robotic lobectomy program. In this review, we evaluate the literature on cost of robotic lobectomy and quality of life.
The results suggest that early experience in a robotic lobectomy program may be associated with relatively higher
index hospital costs when compared to video-assisted thoracoscopic surgery; however, with increased experience
and volume, the difference may no longer be of significance. When compared with thoracotomy, the cost is
comparable if not less costly and may even be profitable for the hospital. Quality of life appears to be acceptable in
the early experience of robotic lobectomy.

Keywords: Robotic, thoracic surgery, lobectomy, cost, quality of life, patient reported outcomes

INTRODUCTION
The surgical approach for pulmonary lobectomy has significantly changed over time. Two decades ago,
the majority of lobectomies were performed via thoracotomy. Over time, surgeons began to adopt video-
assisted thoracoscopic surgery (VATS) and an increased proportion of lobectomies were performed
using this minimally invasive approach. The da Vinci Surgical System (Intuitive Surgical; Sunnyvale,
California, USA) later provided an alternative platform. The proportion of lobectomies after introduction

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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