Robotic Lung Cancer Surgery: A New Era of Minimally Invasive Treatment

Seoul National University Bundang Hospital has pioneered a groundbreaking robotic lung cancer surgery technique that promises to significantly reduce post-operative pain and improve patient quality of life. After three years of clinical research, the hospital has demonstrated the safety and effectiveness of “intercostal preservation robotic lung cancer surgery,” a method that avoids damage to critical nerves responsible for breathing-related pain.

The Problem with Traditional Lung Cancer Surgery

Conventional lung cancer surgery often involves accessing the lungs through incisions between the ribs (intercostal spaces). This approach inevitably risks damaging the intercostal nerves, leading to a debilitating condition known as intercostal neuralgia. Intercostal neuralgia causes severe pain with each breath following surgery and can significantly impair respiratory function, negatively impacting a patient’s overall well-being.

How Intercostal Preservation Robotic Surgery Differs

In 2022, Professor Woohyun Jeong of the Department of Cardiovascular and Thoracic Surgery at Seoul National University Bundang Hospital performed the world’s first intercostal preservation robotic lung cancer surgery. This innovative technique utilizes a surgical robot to access the lungs from under the lowest ribs – an area where intercostal nerves are absent. By avoiding the intercostal nerves altogether, the surgery eliminates the risk of nerve damage and subsequent pain. The precision of the robotic system, with its long and freely rotating instruments, allows for accurate surgical maneuvers even in hard-to-reach areas of the lung. This method is also being adopted in medical centers in the United States and Canada.

Clinical Trial Results: Safety and Efficacy

A three-year clinical study, conducted from June 2022 to June 2025, involved 102 patients with non-small cell lung cancer. The results, published in the Journal of Robotic Surgery, the official journal of the Society of Robotic Surgery, demonstrated a high safety profile, with severe complications occurring in only 1.9% of patients (2 out of 102). Researchers found no instances of diaphragm damage, a concern initially raised due to the novel approach. The incidence of pseudohernia – a bulge caused by abdominal wall muscle weakness – was zero, compared to approximately 7.6% in conventional surgeries.

Cancer Treatment Effectiveness Maintained

Crucially, the new surgical method did not compromise cancer treatment efficacy. The research team performed extensive lymph node dissection on 47 patients at high risk of metastasis, removing an average of 20.4 lymph nodes per person – comparable to the number removed in traditional surgeries. Post-operative biopsies revealed undetected lymph node metastases in 23.4% of these patients (11 out of 47), demonstrating the technique’s ability to accurately identify even hidden cancer spread.

Significance and Future Implications

“It is significant in that it has proven that lung resection and lymph node resection at the same level as existing surgical methods is possible even as dramatically reducing post-surgical pain,” stated Professor Jeong Woohyun. This new approach represents a major advancement in lung cancer surgery, offering patients the potential for a faster recovery, reduced pain and an improved quality of life without sacrificing the effectiveness of cancer treatment.

About Seoul National University Bundang Hospital

Seoul National University Bundang Hospital is a leading medical institution located in Seongnam-si, Gyeonggi-do, South Korea. The hospital provides comprehensive medical services and is dedicated to advancing medical research and innovation. Learn more about Seoul National University Bundang Hospital.