Building on a decades-long reputation for innovation in thoracic surgery, UC San Francisco’s Thoracic Surgery and Oncology Clinic has improved the overall experience for patients undergoing lung and esophageal cancer treatment while continuing to maintain strong outcomes. With leadership in robotic-assisted surgery – a minimally invasive approach – the team has not only maintained very high survival rates but has enabled the majority of its patients to recover faster than had they undergone open surgery. The procedure is now used with more than 90 percent of esophageal cancer surgeries and 70 percent of lung cancer surgeries at UCSF. 

The advantages for patients are many – from shorter hospital stays and fewer post-op complications to less pain management needed postoperatively. Most patients can leave the hospital in one or two days and experience minimal scarring. And while patients undergoing open surgery require an epidural to manage pain following the procedure, the majority of those undergoing the less invasive approach typically do not. Furthermore, most in the latter group can stop narcotic pain medication after two or three weeks and are able to return to work or other normal activities by that time. Given concerns about opioid usage and the possibility of addiction post-surgery, this advantage is significant.

“Although without a doubt most patients would be willing to undergo whatever it takes to save their lives, the ability to have a less invasive procedure without compromising the outcome is of course a great relief to them,” says David M. Jablons, MD, section chief of UCSF’s Thoracic Surgery Program.

Robotic-assisted surgery has been used for certain other procedures for many years, but bringing it into the thoracic field – particularly for lung cancer, the dominant cancer killer – has been a relatively new arrival and indeed a game changer. And the advantages go beyond a better patient experience. The procedure allows for more complex procedures that couldn’t be accomplished via a minimally invasive approach using video-assisted surgery alone. There is greater control, thanks to wristed instrumentation, and enhanced three-dimensional visualization. There also is evidence that robotic-assisted surgery may allow for superior lymph-node dissection.

Commitment to excellence leads to strong outcomes

An innovative procedure in and of itself does not result in the positive outcomes that both surgeon and patient want to see. UCSF’s thoracic oncology team has developed a program that ensures that robotic-assisted surgery leads to the best results possible, in terms of both survival and the patient experience. 

“We’ve worked for many years to perfect our surgical and post-op procedures – first and foremost to improve outcomes, but also the patient’s quality of life,” says Johannes R. Kratz, MD, UCSF’s director of Minimally Invasive and Robotic Thoracic Surgery. “By working diligently to provide state-of-the-art care, combining our clinical skill and training with cutting-edge research, we’re offering patients the best opportunity to survive and thrive at a most challenging and difficult time in their lives.”