Robotic sleeve lobectomy-technically possible but is it being overused?

Dr. Luo and colleagues present an excellent article and video describing their robotic-assisted right upper lobectomy. They use an Si Davinci system and have a 3-port plus assistant-port approach. The dissection is performed using monopolar hook cautery with an assistant port for suction dissection and assistance with knot tying. The manuscript joins a number of other recent papers documenting technical methodology and small cohort series of sleeve lobectomies (1-3). What this manuscript lacks, is what plagues the other manuscripts is on “why” robotic sleeve lobectomy should be performed. Yes, sleeve lobectomy allows patients to avoid a possible pneumonectomy. But are all sleeve lobectomies needed? Or, could bronchoplasty or just primary closure of the bronchial stump be performed?