einstein (São Paulo). 19/Jun/2026;24(Suppl 3):eED0001.
Minimally invasive thoracic surgery: beyond the access route – have we truly become minimally invasive?
DOI: 10.31744/einstein_journal/2026Suppl_3ED0001
Yet an important question remains. Can a procedure truly be considered minimally invasive if only the incision is minimal?
A robotic lobectomy performed through four 8-mm ports cannot be considered fully minimally invasive if it is followed by routine intensive care admission, prolonged chest tube drainage, delayed mobilization, multiple unnecessary investigations, and several days of hospitalization. While we have successfully minimized the surgical access, we have not always minimized the overall burden of treatment imposed on the patient.
Historically, postoperative pathways were designed for patients undergoing thoracotomy. These practices were justified by the significant physiological insult associated with open surgery. However, modern minimally invasive techniques have fundamentally changed the postoperative trajectory of many patients. Continuing to apply traditional perioperative practices to contemporary surgical procedures may prevent patients from fully benefiting from the advances achieved in the operating room.
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