Robotic Lung Cancer Surgery via Subcostal Approach Proven Safe and Reduces Pain

Bundang Seoul National University Hospital Research Team
First Validation of the "Intercostal Nerve-Sparing" Approach That Avoids Nerve Damage
Severe Complications Observed in Only 1.9% of 102-Patient Prospective Study

A new robotic lung cancer surgery technique that approaches the lung from beneath the ribs, thereby avoiding intercostal nerve damage, has proven to be both safe and effective. This method is drawing attention because it reduces postoperative pain while delivering treatment outcomes equivalent to those of conventional surgery.

On March 23, Bundang Seoul National University Hospital announced the results of a clinical study on the “intercostal nerve-sparing robotic lung cancer surgery,” developed by Professor Jung Woo-Hyun of the Department of Cardiovascular and Thoracic Surgery. The research findings were recently published in the international journal Journal of Robotic Surgery.

It is standard practice in lung cancer surgery to insert instruments between the ribs. However, this can result in intercostal nerve damage, which may lead to postoperative pain and decreased respiratory function in many cases.

To address these limitations, Professor Jung became the first in the world in 2022 to introduce a new approach that inserts robotic instruments beneath the lowest rib instead of between the ribs. By utilizing a path that avoids the intercostal nerves, this structure fundamentally minimizes nerve damage.

The research team conducted a prospective study on 102 patients with non-small cell lung cancer from June 2022 to June 2025. As a result, there were only two cases of severe complications, resulting in an incidence rate of 1.9%. No diaphragmatic injuries, which had been a concern during the procedure, were observed, and no pseudohernia was reported—whereas this occurs in approximately 7.6% of conventional surgeries.

In terms of therapeutic efficacy, there was no difference compared to conventional surgery. The team confirmed that an average of 20.4 lymph nodes were dissected per patient, a level similar to that of existing surgical methods. Notably, in about 23.4% of patients, lymph node metastases that were not detected in preoperative imaging were additionally discovered, thereby improving the accuracy of cancer staging.

However, further research is needed for quantitative assessment of patient quality of life, including the pain reduction effect and long-term improvement in respiratory function. Currently, such data are still limited.

Professor Jung, who led the study, stated, “The significance of the ‘intercostal nerve-sparing robotic lung cancer surgery’ lies in the fact that it has been proven to dramatically reduce postoperative pain while enabling lung and lymph node resections at a level equivalent to conventional methods.” He added, “We will continue to analyze its effects on pain reduction, respiratory function preservation, and overall quality of life going forward.”

This content was produced with the assistance of AI translation services.