Abstract
Lobectomy remains standard treatment for stage I non-small cell lung cancer (NSCLC). However, highly sensitive low-dose computed tomography (LDCT), increasingly used for screening high-risk individuals, is diagnosing more patients with small early stage NSCLC who may be adequately treated by sublobar resection. This is being investigated by ongoing trials. Minimally invasive video-assisted and robot-assisted thoracoscopic surgery is reducing perioperative morbidity and mortality, improving postoperative lung function, and is oncologically equivalent to open surgery. This paper reviews data on the use of segmentectomy to treat early stage lung malignancies and presents initial experience on the use of robot-assisted surgery to perform segmentectomy. Long-term follow-up and direct comparisons with open surgery and video-assisted thoracoscopy surgery are necessary. However—and notwithstanding the high cost of robotic systems—robotic segmentectomy appears to be appropriate treatment for the increasing numbers of small non-aggressive lung cancers being diagnosed by LDCT screening.
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