General Thoracic

More than 40 thoracic surgeons nationwide gathered in Norcross, Georgia, on May 15-16 to attend the STS Workshop on Robotic Thoracic Surgery. This immersive, two-day event offered participants critical insights and hands-on training to enhance their planning and execution of both routine and advanced robotic thoracic procedures.

The workshop featured two tracks tailored to experience levels: Foundations and Advanced.

Foundations Track Focuses on Core Techniques

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The program focused on core robotic procedures such as lobectomy, thymectomy, and segmentectomy, with an emphasis on port placement, energy use, and robotic navigational bronchoscopy. The sessions included topics like 3D imaging, preoperative planning for lung segmentation, management of intraoperative complications, thymectomy techniques, and strategies for establishing a robotic surgery program. This encompasses securing hospital support and engaging leadership.

"Building a robotic thoracic surgery program involves more than just enhancing technical skills," said co-course director Brian Mitzman, MD. "It requires securing adequate block time and robotic access, obtaining hospital support for marketing the program to the community, and effectively communicating with hospital leadership."
 

Advanced Track Tackles Complex Cases

The program addressed complex procedures such as sleeve resections, esophagectomy, and challenging segmentectomies. Courses covered both typical and atypical lung segments, pneumonectomy techniques, vascular control in difficult cases, tracheobronchoplasty, first rib resection, and best practices for esophageal conduit preparation.
 

Hands-On Experience and New Technology Integration

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Participants in both tracks trained with cutting-edge tools, including single-port (SP) robotic systems, advanced bronchoscopy platforms, and next-generation imaging. More than six hours of lab-based training at a state-of-the-art facility were paired with expert-led lectures and interactive case discussions.

“As an attending thoracic surgeon at Emory University, it was a privilege to teach at the STS Workshop,” said Alicia Bonanno, MD. “I was especially excited to guide new learners through innovative, up-and-coming robotic techniques that are shaping the future of thoracic surgery.”

This intensive workshop provided valuable, practical experience to enhance skills in robotic thoracic surgery and encourage innovation in patient care. With an approximate 2:1 faculty-to-attendee ratio, participants received personalized guidance tailored to their individual goals and experience levels.

“My first day at the workshop was incredibly informative. During the hands-on session, I had the opportunity to perform a lobectomy alongside Dr. Andrew Brownlee and learned lots of valuable tips and tricks from him,” said Jerome Lee, MD, a general surgery resident at Bayhealth Medical Center in Dover, Delaware.

"The STS Workshop is a distinguished program where each faculty member is carefully selected for their specialized expertise," said Dr. Mitzman. "Attendees were matched with instructors based on their specific needs, ensuring personalized instruction and meaningful feedback throughout the symposium."

With its emphasis on individualized instruction and technical innovation, this intensive workshop remains a premier training ground for surgeons aiming to elevate their robotic thoracic surgery skills and shape the future of the specialty.

Check out the event photo gallery. 

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Reassessing Efficacy: Understanding Failures in Lung Cancer Screening Despite Low-Dose CT Protocol Adherence, a study presented at the 2025 STS Annual Meeting by Case Western Reserve University medical student Victoria Shiqi Wu, analyzes clinical and demographic factors contributing to lung cancer deaths among patients undergoing low-dose CT (LDCT) screening. Despite the substantial benefits of LDCT in detecting lung cancer early, some patients still succumb to the disease, raising important questions about the effectiveness of current screening approaches for certain populations.

The study utilized data from the National Lung Screening Trial, examining 16,081 patients with negative (normal) initial LDCT scans. Screening success was defined as either remaining cancer-free or surviving lung cancer. Screening failure was characterized by:

•    Receiving three negative scans but dying of lung cancer.
•    Being diagnosed with stage 4 lung cancer.
•    Having a positive scan but still succumbing to the disease.
 

Key Findings

Out of the total cohort, 98.1% (15,775 patients) experienced screening success. Among the 306 patients diagnosed with lung cancer, 33.3% had successful outcomes, while 66.6% faced screening failure.

The study identified several factors significantly associated with screening failure, including:

• Age over 70: Patients in this age group faced a 2.65 times higher risk (95% CI: 1.66-4.12).
• Male sex: Male patients were 1.56 times more likely to experience failure (95% CI: 1.13-2.17).
• Current smoking: Smokers had a 2.03 times higher likelihood of screening failure (95% CI: 1.52-2.73).
• Chronic obstructive pulmonary disease (COPD): Patients with COPD had 2.20 times the risk (95% CI: 1.35-3.46).
• Emphysema and sarcoidosis: Patients with these conditions faced elevated risks, with sarcoidosis showing an especially strong association (OR=7.99; 95% CI: 1.24-29.0).
• Firefighting work: Although less common, individuals in this occupation showed higher failure odds (OR=2.14; 95% CI: 0.99-4.07).
  Implications

The findings underscore the need for tailored interventions to improve LDCT screening outcomes for high-risk populations. Enhanced strategies may include:

•    Developing personalized screening protocols.
•    Implementing more aggressive smoking cessation programs.
•    Increasing surveillance for patients with comorbidities like COPD and emphysema.
 

The study highlights the importance of understanding the limitations of LDCT screening and targeting vulnerable groups to maximize its lifesaving potential. By addressing the identified risk factors, healthcare providers can take meaningful steps toward reducing lung cancer mortality.