Development of Robot Surgery Method Without Intercostal Neuralgia, a Common Aftereffect of Lung Cancer Surgery

Professor Jung Woo-hyun, Department of Thoracic Surgery, Bundang Seoul National University Hospital

The "Intercostal Nerve-Sparing Robotic Lobectomy" developed by Professor Jung Woo-hyun of the Department of Thoracic Surgery at Bundang Seoul National University Hospital has the advantage of not passing through the intercostal space, thus preventing complications such as intercostal neuralgia.
[Photo by Bundang Seoul National University Hospital]

Domestic medical professionals have developed a new surgical technique that eliminates 'intercostal neuralgia,' a common complication after lung cancer surgery.

On the 27th, Bundang Seoul National University Hospital announced that Professor Woo-Hyun Jeong of the Department of Thoracic Surgery devised and performed the world's first 'intercostal nerve-sparing robotic lung resection,' which involves making an incision under the lowest rib and using a surgical robot instead of thoracoscopy to remove the lung.

Until now, lung cancer surgery typically involved making 2 to 3 small holes between the ribs to insert a thoracoscope and resect the lung. However, since the intercostal nerves are located at the incision sites, there was a high risk of nerve damage and complications after surgery. When the intercostal nerves are damaged, patients suffer from sharp or stabbing pain every time they breathe for life. This pain, known as intercostal neuralgia, occurs in about 40% of patients even after successful lung cancer surgery, worsening their quality of life and prognosis.

Professor Jung Woo-hyun, Department of Thoracic Surgery, Bundang Seoul National University Hospital.

The surgical method devised by Professor Jeong involves making an incision at the very bottom of the ribs, avoiding cutting between the ribs, thereby preventing intercostal neuralgia. Although there have been attempts like this before, limitations of surgical instruments made it difficult to secure the necessary angles and views to safely resect the lung. Professor Jeong solved this by using a surgical robot that can freely rotate and adjust angles inside the body. Over the past two years, more than 50 cases have been performed successfully.

Professor Jeong explained, "Even if lung cancer surgery is successful, many patients experience pain or discomfort every time they breathe due to intercostal nerve damage, leading to a long-term decline in quality of life. This surgical method operates through an area where intercostal nerves do not exist, so there is no related neuralgia or complications." He added, "Since the intercostal nerves also control respiratory muscles, this method is advantageous for lung rehabilitation after surgery. We will continue research to further develop this surgical technique."

The newly developed surgical method was published in 'JTCVS Techniques,' a leading international journal issued by the American Association for Thoracic Surgery.

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