74-year-old once declared inoperable successfully undergoes robotic lung cancer surgery

A 74-year-old retired defence civilian from Uttarakhand, who was earlier told he was too high-risk for lung cancer surgery because of severe breathing problems and uncontrolled diabetes, has successfully undergone robotic lung cancer surgery at Apollo Hospitals, Bannerghatta Road, Bengaluru — offering new hope for elderly and medically fragile cancer patients who are often denied curative treatment.The patient, a father of four, had been battling persistent breathlessness and declining health when he was diagnosed with lung cancer. However, his severe Chronic Obstructive Pulmonary Disease (COPD), poor lung reserve, and diabetes made conventional open chest surgery extremely risky. He was told that surgery would not be done in his hometown as his lungs may not tolerate the procedure or recover well after a surgical procedure. Determined to give him a chance to be cured, specialists with Apollo Hospitals at Bannerghatta Road developed an all-encompassing prehabilitation program for the patient to be able to achieve enough fitness prior to surgery to be able to tolerate the surgery. The patient participated in pulmonary rehabilitation, performed breathing exercises, received chest physiotherapy, and had their nutrition optimised, plus needed stabilisation before undergoing surgery with a multidisciplinary thoracic oncology team. The patient had sufficient improvement following this intensive rehabilitation period and was then able to undergo a robotic lobectomy, which is a minimally invasive procedure to remove the portion of his lung that was affected by cancer along with systematic mediastinal lymph node dissection in order to provide complete treatment for his lung cancer.Unlike conventional thoracic surgery, which requires a large incision and rib spreading, robotic surgery is performed through tiny keyhole incisions using advanced robotic technology that allows surgeons greater precision and control while reducing trauma to the chest.The minimally invasive approach also allowed precise lymph node dissection and adherence to standard oncological principles while reducing postoperative trauma.Patients with severe COPD and poor lung reserve are often considered unfit for major lung cancer surgery because recovery itself can place enormous stress on breathing. In this case, the challenge was not only removing the cancer safely, but ensuring the patient could recover without worsening respiratory compromise.Robotic surgery helped us avoid a large chest incision and rib spreading, which can be particularly difficult for patients with weak lungs. Combined with meticulous prehabilitation, it allowed us to offer curative treatment to a patient who otherwise may not have had a surgical option.Despite being categorised as a high-risk surgical candidate, the patient’s recovery was smooth. He resumed oral intake on the same day as surgery and was mobilised the following day. Postoperative pain remained minimal and was managed with oral medications alone, enabling faster recovery and earlier return to routine activity.Robotic thoracic surgical procedures provide potential opportunities for curative treatment to carefully selected elderly or high-risk lung cancer patients by decreasing surgical trauma to the lungs, reducing post-operative pain in patients after surgery, and minimizing the potential for pulmonary complications. Currently, the patient is recovering well after his surgery and is performing his regular day-to-day activities confidence and comfort.Dr. Suraj Manjunath, Senior Consultant Surgical Oncologist, Apollo Hospitals Bangalore