Authors' objectives: HTW assessed the effectiveness of robot-assisted thoracic surgery for lung resection or anterior mediastinal mass excision and compared outcome measures with conventional treatment using video-assisted thoracoscopic surgery (VATS) or open surgery. This is an updated version of an appraisal. HTW originally published Guidance on this topic in September 2019.

Authors' results and conclusions: HTW’s Guidance currently does not support routine adoption of robot-assisted thoracic surgery as while it shows promise, there is a lack of evidence about its long term effects. Further research is need on the long-term impacts and on patient experience.

Authors' recommendations: The evidence does not support the routine adoption of robot-assisted thoracic surgery. The current evidence suggests equivalent clinical outcomes but uncertainty about any improvement in short and long term clinical effectiveness of robotic thoracic surgery as compared to standard of care (open or video-assisted thoracic surgery). The economic analysis suggests that robotic thoracic surgery is not cost effective compared to video-assisted thoracic surgery although there is uncertainty around some key aspects of the analysis.

Authors' methods: The Evidence Appraisal Report is based on a literature search (strategy available on request) for published clinical and economic evidence on the health technology of interest. It is not a full systematic review but aims to identify the best available evidence on the health technology of interest. Researchers critically evaluate and synthesise this evidence. We include the following clinical evidence in order of priority: systematic reviews; randomised trials; non-randomised trials. We only include evidence for “lower priority” evidence where outcomes are not reported by a “higher priority” source. We also search for economic evaluations or original research that can form the basis of an assessment of costs/cost comparison. We carry out various levels of economic evaluation, according to the evidence that is available to inform this.

Project Status: Completed

Year Published: 2023

URL for published report: https://www.healthtechnology.wales/reports-guidance/robot-assisted-thoracic-surgery/

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Wales, United Kingdom

Organisation Name: Health Technology Wales

Contact Address: c/o Digital Health Care Wales, 21 Cowbridge Road East Cardiff CF11 9AD

Contact Name: Susan Myles, PhD

Contact Email: healthtechnology@wales.nhs.uk