Emergency Conversion During Robotic-Assisted Thoracic Surgery

Dena G Shehata; Ammara A Watkins; Elliot L Servais

doi:10.1016/j.thorsurg.2025.04.001

Emergency Conversion During Robotic-Assisted Thoracic Surgery

Thorac Surg Clin. 2025 Aug;35(3):279-283. doi: 10.1016/j.thorsurg.2025.04.001. Epub 2025 May 17.

Authors

Dena G Shehata¹, Ammara A Watkins², Elliot L Servais³

Affiliations

¹ Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA. Electronic address: https://twitter.com/DenaShehata__.
² Department of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA; Tufts University School of Medicine, Boston, MA, USA. Electronic address: https://twitter.com/ammara_a.
³ Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA; Tufts University School of Medicine, Boston, MA, USA; UMass Chan Medical School, Worcester, MA, USA. Electronic address: elliot.servais@lahey.org.

PMID: 40619175
DOI: 10.1016/j.thorsurg.2025.04.001

Abstract

This article focuses on the critical aspects of emergency conversion from robotic-assisted thoracoscopic surgery (RATS) to open thoracotomy. Despite the superior visualization and control offered during RATS, conversion to a thoracotomy is occasionally necessary due to complications such as major vascular injury. Conversion is a high-stakes event, associated with increased morbidity and mortality, and requires careful preoperative planning, clear intraoperative communication, frequent simulation, and a systematic process to ensure patient safety.

Keywords: Conversion; Intraoperative emergency; Robotic surgery; Thoracic surgery.

Publication types

Review

MeSH terms

Conversion to Open Surgery* / methods
Emergencies
Humans
Robotic Surgical Procedures* / methods
Thoracic Surgery, Video-Assisted* / methods
Thoracoscopy* / methods
Thoracotomy* / methods