Latest / Talking FACS / Robots in the OR: How Robotic Surgery is Transforming Lung Cancer Care

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Robots in the OR: How Robotic Surgery is Transforming Lung Cancer Care · Talking FACS

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  Welcome to Talking FACS, and thank you for tuning in to Cancer Conversations
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  on Talking FACS, a podcast collaboration between the University of Kentucky
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  Markey Cancer Center and the UK Martin Gatton College of Agriculture,
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  Food and Environments Cooperative Extension Service.
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  We will share with you the latest developments in cancer prevention,
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  diagnosis, treatment and research from the experts at Markey Cancer Center,
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  Kentucky's only National Cancer Institute designated Comprehensive Cancer Center.
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  Talking Facts is hosted by the UK Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families and communities
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  to improve quality of life.
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  When people hear robotic surgery, they often imagine a robot doing the operation
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  all by itself, but that's really not the case.
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  Robotic surgery is actually a high-tech tool that helps surgeons work with incredible precision.
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  It's all about giving patients a gentler, less invasive option for treatment.
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  Welcome to Cancer Conversations on Talking Facts, where we share the latest
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  research and advancements in cancer care from the experts at UK's Markey Cancer Center.
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  I am your host, Mindy McCulley, Extension Specialist for Instructional Support
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  with Family and Consumer Sciences Extension.
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  My guest today is Dr. Mansi Shah, Assistant Professor in the Department of Thoracic Surgery.
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  Our topic is Using Robotic Surgery to Treat Lung Cancers. Welcome, Dr. Shah.
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  Thank you. Thanks for having me. I think that this is going to be a very interesting
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  conversation because I'm all about the tech.
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  So, I'm excited to, first of all, understand what exactly is robotic surgery
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  and how it is used to treat lung cancers?
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  Yeah, so it's basically a tool that we use.
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  The goal being that we can treat patients and offer patient surgery through small cuts.
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  So the traditional or what we would call old-fashioned surgery is through a
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  big cut, what we call thoracotomy.
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  That's when people thinking about being split open and their chest spread open,
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  that's the thoracotomy.
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  But with that comes a lot of pain, a longer recovery, longer time in the hospital.
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  So what we've tried to do over time is make that incision as small as possible
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  so that people can recover faster and get back to their life faster.
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  And it allows us to offer surgery to a broader population of people.
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  So robotic surgery is just one of these minimally invasive surgical techniques.
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  Okay, so are patients given options or is robotic surgery used at the discretion of the surgeon?
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  So it is a technique that's at the discretion of the surgeon.
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  I would say as a patient, you really want to be looking for someone that can
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  offer you minimally invasive surgery.
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  Within thoracic surgery, there's really two forms of minimally invasive surgery.
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  There's what we call video-assisted thoracic surgery, which is still through
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  small cuts, but it's different instruments.
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  So the instruments are more straight with just a single point of a joint.
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  Robotic surgery is a different form of minimally invasive surgery.
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  And I think that's where the technology has advanced.
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  So the camera is actually a 3D camera as opposed to a 2D camera.
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  And the instruments have more joints to them.
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  So it actually provides a more natural motion similar to a wrist and fingers of a human.
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  And so it allows more options from a surgical technical standpoint.
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  So it's still minimally invasive surgery either way. And it's really just up
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  to the surgeon and their expertise and their level of familiarity with the technology.
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  So as you said, this is emerging from the old-fashioned surgery to new advances.
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  Guessing that you had to have additional training to develop the skills to do the robotic surgery?
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  Yeah, so it does take a specialized training.
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  Now, that could be during your training for thoracic surgery,
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  there are fellowships specific to robotic surgery, and then there's,
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  for surgeons that are already out of training,
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  there's specific training for robotic surgery and protocols and,
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  you know, different didactics and things that you have to do to show a level
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  of competency to be able to do this independently on your own.
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  So what are the main benefits of choosing robotic surgery for lung cancer?
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  So in my perspective, I think the technology for robotic surgery is where advancements have been made.
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  So the visualization, I think is phenomenal.
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  You get 3D, you get a 3D camera.
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  So the visualization of the anatomy, I think is, is very good.
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  And the, the surgical instruments I think have progressed.
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  So like I was saying there, what we call wristed instruments,
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  you get a greater range of motion inside what is a pretty tight space.
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  If you think of the chest cavity, it's a rigid space because of the ribs, it's a fixed space.
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  So not a lot of working room. So the ability to have instruments that have a
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  greater range of motion and a broader array of instruments to choose from.
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  Provide some benefit. And then within robotic surgery,
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  there's actually different platforms, meaning that there's different types of
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  robots that you can use depending on what the patient needs.
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  So we have three main categories of robotic platforms.
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  So one is a robotic bronchoscope.
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  We call it navigational bronchoscopy, and we use that to actually biopsy nodules
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  that are deep into the lung, so it allows for precision in biopsy and diagnosis.
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  And then from a surgical standpoint, we have two types of robots.
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  One is called a multiport robot, where you have multiple small cuts,
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  usually about 8 to 12 millimeters. and within each cut you can put one single instrument.
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  So the patient will have multiple cuts and through each cut you put a you know
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  either a camera or a separate instrument.
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  And so those are smaller cuts but you get more of them.
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  The most recent technology especially in thoracic surgery is what we call a single port robot.
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  So that's another platform where now instead of multiple small cuts.
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  It's just one cut and we can put a camera and multiple instruments through that one cut.
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  So we've gone from one big cut to multiple small cuts to a single small cut.
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  And we can do surgery through that. And so there's just different options,
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  but all with the goal of trying to minimize pain for patients,
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  make recovery as fast as possible, and get people out of the hospital and back
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  to their lives as quickly as possible.
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  Is there a situation where someone is not a good candidate for robotic surgery?
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  That's a good question because, yes, robotic surgery is not possible for every situation.
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  There are some tumors that are very large or very central or tumors that are
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  growing into the airway or blood vessels where robotic surgery may not be possible
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  or safe and an open technique may be necessary.
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  But as much as possible, we try to do things through a minimally invasive approach
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  if it's safe to do so. Okay.
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  So what does the future look like for robotic surgery? Could it become just
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  a, I guess maybe it already is the standard for lung cancer treatment?
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  I think right now, minimally invasive surgery is certainly the standard.
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  There's still folks that prefer, you know, surgeons that prefer the video-assisted
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  thoracic surgery approach over the robotic surgery approach.
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  I think there's more and more people over time that are adopting the robotic
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  technique. I think the future of robotic surgery is going to be this single port platform.
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  It's new within the field of thoracic surgery.
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  The equipment has been around. It was used by ear, nose, and throat surgeons
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  and urologic surgeons for a long time.
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  It was just approved for thoracic surgery in 2024, so just a little over a year ago.
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  And I think that's where the advancements are going to be.
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  Because again, we're really trying to do whatever we can to minimize pain for
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  patients and quicken recovery.
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  And being able to do complex surgery through one small single cut,
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  I think is really going to be the future for patients for robotic thoracic surgery. Right.
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  Well, I appreciate this time that you have given to me to talk about this today,
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  because I've been fascinated by all that you've had to share. Oh, thank you.
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  I appreciate your interest and a platform to be able to explain to folks what
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  it is that we can do and what it is that we can offer for patients.
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  It's a great opportunity, so I appreciate it.
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  Definitely. I think anytime that we can reduce pain and speed up the recovery
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  process, then it's a win-win, right?
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  Absolutely. Yeah, absolutely. As I said, thank you for your time.
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  Maybe you'll come back again and we'll talk some more about robots.
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  I'd be happy to anytime. Thank you so much.
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