Abstract
Robotic-assisted pulmonary lobectomy may be considered for any patient undergoing lobectomy that does not involve complex vascular or airway reconstruction, or chest wall resection. The advantage of minimally invasive chest wall resection, which avoids rib spreading but still resects ribs, is controversial. In our opinion and based on our considerable experience, we favor thoracotomy when chest wall resection is required. Tumors larger than 7 cm (T3), tumors crossing fissures, and centrally located tumors may all be considered for robotic lobectomy with proper patient selection and increasing surgeon experience, but, in general, these factors are relative contraindications to a robotic approach. However, radiologic evidence of N1 nodes, induction chemotherapy and/or radiation, calcified lymph nodes, and prior thoracic surgery are not contraindications to robotic lobectomy but a robotic approach should not be selected early in one‘s learning curve. © 2018 by Taylor & Francis Group, LLC.