The expanding use of robotic technology in lung transplantation came under scrutiny at t46th Annual Meeting and Scientific Sessions of the International Society for Heart and Lung Transplantation (ISHLT), where experts debated whether its clinical benefits justify the cost and complexity.
The debate featured Stephanie Chang, MD, a Thoracic and Transplant Surgeon at NYU Langone Health, arguing in favor of robotics, and Hermann Reichenspurner, MD, PhD, a retired Surgeon and pioneer in minimally invasive cardiothoracic surgery, presenting the counterpoint.
Robotic-Assisted Thoracic Surgery May Expand Patient Pool
Dr. Chang highlighted the potential of robotic-assisted surgery to improve recovery and expand access to transplantation.
“Robotic, minimally invasive approaches can reduce the physiologic stress of transplantation compared with traditional, large access incisions,” she said.
Dr. Chang noted that in lung transplantation, robotic techniques offer:
- smaller incisions and improved visualization
- less bleeding and fewer hemodynamic shifts
- potential reductions in kidney injury, pain, and hospital stays.
“As robotic techniques become faster and more widely adopted, more frail and older patients may become candidates for transplant,” she said.
In contrast, Dr. Reichenspurner emphasized that current evidence does not demonstrate superior patient outcomes with robotic approaches compared to established minimally invasive techniques. “There is not a single comparative study showing a significant advantage of robotic systems in terms of survival, morbidity, or length of stay,” he said. “Outcomes are comparable, but not better.” Dr. Reichenspurner, who has performed approximately 450 heart transplants and is a past president of ISHLT, was an early adopter of robotic and minimally invasive cardiac surgery in the late 1990s. He stressed that his position reflects experience, not resistance to innovation.
