“Future perspectives in minimally invasive lung sparing surgery”. This is the title of the international workshop that took place at Humanitas on May 11-12, directed by Doctor Giulia Veronesi, Supervisor of the Robotic Surgery Section – Thoracic Surgery at Humanitas, by Professor Marco Alloisio, Supervisor of Thoracic Surgery at Humanitas, and by Doctor Piergiorgio Solli.

As Doctor Giulia Veronesi explains, “A workshop is an important chance of debate and training. In the last years, an early diagnosis of lung cancer allowed the discovery of increasingly smaller tumors. This is only possible by adapting the operational procedures and by extending lung resections. In fact, nowadays we aim to a sublobar resection in order to save a significant amount of healthy tissue”.

The evolution of surgery

“Thoracic surgery made huge leaps towards ways to save the healthy lung tissue, as was the case with breast cancer. In fact, in the beginning, surgery consisted in the removal of the lung (pneumonectomy) with an open surgery. Then, there was lobectomy. That, only removed a part (lobe) of the lung in an open surgery, with the same results as the partial removal. Technological and technical developments, then led us to video-assisted thoracoscopic surgery (VATS) for lobectomy and then to segmentectomy via VATS. This technique reduced complications and postoperative deaths by far.

However, this kind of surgery is not easy to perform and badly trained surgeons may choose an open surgery instead of the newer, more effective techniques of traditional or robotic VATS with minimally invasive segmentectomy”.

Aim and topics of the workshop

“On the occasion of this workshop, we compared traditional and robotic VATS, spoke about different techniques for different operations and got updates pertaining to new technological (mainly robotic) developments.

We paid attention to new diagnostic tools, such as bronchoscopic navigation (allowing surgeons to locate tiny lumps) and non-invasive treatments such as stereotactic radiotherapy.

Also, we reviewed progress on the lung cancer screening, an important topic we are really keen on. We want to broadcast screening techniques in Europe, as it is already well-known in the US. This is a difficult topic, because Europe has little money to spend and increasing health costs”, Doctor Veronesi says.

An ever more precise surgery

There was much room for surgery, with a video session presenting different techniques that use new tools (such as the mechanical stapler).

“Surgical resection is becoming ever more personalized. The surgeon has to evaluate, on a case by case basis, how to proceed, by keeping into consideration the risk factors for each patient. In particular, CT lump density, dimension and position are paramount to choose a lobe surgery or a segmentectomy”, Doctor Veronesi says.