Editorial on expanded indications for robotic surgery in stage IIIA non-small cell lung cancer

The authors present their operative technique of a three-arm robot assisted thoracoscopic lobectomy for locally advanced non-small cell lung cancer (NSCLC) with N2 disease using the da Vinci S system. They utilize 3 small robotic incisions and a utility incision. Cheng et al. have a large experience with this technique, having performed over 1,000 lung resections since 2009. This is a modification of the original description put forth by Park et al. for a robotic assisted lobectomy, which utilized 2 small incisions and a utility incision (1), and a variation of the four-arm technique described by Veronesi et al. (2). Here, the authors state that their technique has the benefit of minimizing the use of unnecessary arms and instruments, use of only 4 incisions (instead of 5 with the four arm technique as has become more common recently), and no need for undocking of the arms to remove specimens.