Robotic-assisted thoracoscopic segmentectomy: there is a long way to go

We appreciate the reviewer’s excellent comments regarding robotic-assisted thoracoscopic S6 segmentectomy (1). We agree that there is no standardized technique for the video-assisted thoracic surgery (VATS) approach, but without a doubt, the future of surgery is going in the direction of single port access and robotics. The advantages of robotic VATS (R-VATS) over conventional VATS include an additional four degrees of freedom (internal pitch, internal yaw, rotation, and grip), elimination of the fulcrum effect, superior 3-D vision from the binocular camera, tremor filtration, and improved ergonomic positioning for the surgeon (2-4). The 5-year overall survival of stage I non-small cell lung cancer for the robotic, VATS, and open matched groups were 77.6%, 73.5%, and 77.9%, respectively, and there was no statistically significant difference between the groups (5). However, R-VATS has been associated with reductions in mortality, length of hospital stay, and overall complication rates when compared to both open and VAT surgeries (6)