Key Takeaways
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- Robotic-assisted surgery is less invasive, which means patients recover faster and experience less pain.
- Each generation of technology improves surgical precision.
- The next evolution in robotic surgery involves AI-assisted systems that can provide live feedback during surgery.
- Dr. Areo Saffarzadeh emphasizes that the robot is only a tool and the human connection between surgeon and patient remains key in patient care.
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Not long ago, the idea of robots in the operating room seemed like a science fiction fantasy, not standard medical practice. Today, it’s a reality that’s reshaping patient care. Robotic-assisted surgery has become commonplace in hospitals worldwide, with evolving technology offering new levels of precision and control.
While these surgical machines are impressive, they don’t work alone. Behind every robotic arm is a skilled surgeon and team, guiding each movement with expertise and intent.
“The robot is just a tool of the surgeon,” says Areo Saffarzadeh, M.D., thoracic surgeon and director, Robotic Thoracic Surgery at Providence Cancer Institute of Oregon. “Robotic surgery enhances the abilities and capabilities of that person. If you're able to leverage those things, you can really make a difference."
A brief history of robotic-assisted thoracic surgery
For much of the past century, open thoracic surgery was the standard approach to treating conditions within the chest, including lung and esophageal cancers. Open surgery involves making incisions between the ribs and then enlarging the openings to allow a surgeon’s hands to access the chest.
But open surgery comes with significant drawbacks for patients: more pain, a higher risk of complications and slower recovery.
The first leap toward less invasive treatment came with video-assisted thoracic surgery (VATS). Introduced in the 1990s, VATS gained popularity because it allows surgeons to operate through tiny incisions using a small camera and long, straight instruments. This less invasive approach became widely adopted for many thoracic procedures, such as lung biopsies or removal.
“VATS was a game-changer,” says Dr. Saffarzadeh. “It marked the shift away from open surgery and toward minimally invasive techniques.”
But even VATS has its limitations. The rigid instruments restrict the range of motion, and the 2D camera view requires surgeons to operate without depth perception.
Soon after the first FDA-approved robotic surgery system was introduced in 2000, surgeons began adapting the technology for thoracic procedures. The da Vinci Surgical System opened the door to an entirely new way of performing surgery. With a high-definition 3D camera and surgical instruments that mimic the human wrist, robotic-assisted thoracic surgery was a significant upgrade in dexterity and visualization.
Each generation of technology greatly improves surgical precision and accuracy. “The last version of the robot [da Vinci Xi] allows us to do the entire operation robotically, including stapling, which previously had to be done manually at the bedside,” says Dr. Saffarzadeh.
“VATS is still a useful tool, but robotics takes it further. From my perspective, robotic-assisted surgery is the future. It’s allowed us to take on more challenging cases that previously would have required open surgery. By using minimally invasive techniques patients have lower risk and faster recovery.”
Reducing the time from diagnosis to treatment
Dr. Saffarzadeh is deeply committed to reducing the time between cancer diagnosis and treatment. The wait from biopsy to surgery can sometimes extend beyond four weeks, a delay that research has linked to worse cancer-specific survival.
To close this gap, Dr. Saffarzadeh has implemented a streamlined program for select stage I cancer patients, enabling them to have an endoscopic (minimally invasive, camera-guided) biopsy with immediate analysis. If the results are negative, the patient won’t require surgery. If cancer is confirmed, the patient receives surgical treatment the same day. “This innovative approach not only reduces patient anxiety, but also minimizes hospital visits and time away from work—benefiting both patients and their families,” he says.
The next evolution: AI-assisted robotic surgery
While today’s robotic systems already enhance a surgeon’s vision, dexterity and control, artificial intelligence (AI) will take those capabilities even further. The newest generation of surgical robots are being designed with AI integration that gives them the ability to make decisions.
“Where I see AI making a real impact is in live feedback, while you’re in surgery,” says Dr. Saffarzadeh. “It can tell you how hard you’re pulling on something or highlight that you’re near a critical artery. That kind of support can reduce risk and improve outcomes.”
AI also holds promise beyond the operating room. Advanced imaging tools are already using machine learning to detect lung nodules earlier and more accurately than the human eye. In training, AI can assess a surgeon’s technique and offer real-time coaching.
“At the end of the day, the robot is just a tool,” Dr. Saffarzadeh says. “AI won’t replace the surgeon, but it will make us better. It’s the next step in helping us deliver safer, faster, more precise care.”
Precision meets human connection
For patients, the idea of a robot in the operating room can still feel unsettling. “I always remind them that the robot doesn’t act on its own. Every movement is controlled by me,” says Dr. Saffarzadeh. “It’s not autonomous. It’s a tool I use to do my job better.”
And that job is very personal. From the first consultation to the final post-op visit, the connection between Dr. Saffarzadeh and his patients is key. “There’s something sacred about surgery,” he says. “Patients are entrusting you with their lives.” Even as the technology continues to evolve, the human elements—skill, communication and compassion—remain at the heart of every procedure.
Learn about Providence Cancer Institute Thoracic Surgery
Whether you’ve been diagnosed with lung cancer, thymoma, a chest mass or other condition in the chest, the team at Providence Cancer Institute can help. Learn more about Dr. Saffarzadeh and the Providence Cancer Institute Thoracic Surgery team.
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