Royal Brompton Hospital’s first da Vinci Xi robotic-assisted thoracic surgery

In April 2025, surgeons at Royal Brompton Hospital completed our first robotic-assisted thoracic surgery using the da Vinci Xi, a robotic surgical system by Intuitive Surgical, designed for minimally invasive surgery.

Mr Simon Jordan, consultant thoracic surgeon, led the first procedures and is now working with wider thoracic surgical teams to roll this out further across Royal Brompton and Harefield hospitals. 

360-degree view inside the thoracic cavity 

RATS (Robotic-Assisted Thoracic Surgery) is a minimally invasive procedure carried out using a robotic system through small incisions, whereby our surgeon maintains full control throughout the procedure. Our surgeon sits at a control console next to the patient in the theatre and is aided by surgical assistants. 

The procedure is performed with the patient under general anaesthetic. Our surgeon makes 3 to 5 small incisions, typically ranging from 8-12mm, through which the robot accesses the thoracic cavity. Small instruments and 3D cameras are inserted into the chest cavity, which are attached to the arms of the robot controlled by our surgeon from the console. The screen at the console provides a high-definition 360-degree view inside the chest cavity, and the robot mimics our surgeon’s hand movements on the console in real-time. 

Improved precision and quicker recoveries 

The da Vinci Xi system enables our surgeon to perform procedures with greater dexterity when compared with previously minimally invasive techniques. This results in improved precision.  

The benefits to the patient of RATS surgery include: 

• minimal scarring 
• no rib spreading 
• quicker recovery times 
• reduced bleeding 
• reduced post-operative pain 
• shorter hospital stays 

Shorter hospital stays will allow more patients with lung conditions to be treated each year, thereby improving access to life-saving procedures with our specialist team.  

“This marks a pivotal moment for our thoracic surgery programme at Royal Brompton Hospital,” explains Mr Jordan. “The da Vinci Xi system’s precision and control enable us to deliver the highest level of care to our patients while helping to shorten recovery times. We aim for this to enhance overall outcomes and increase the number of patients we’re able to treat.” 

Treating lung cancer at all stages 

Thoracic surgery (robotic-assisted and open) is one of the recommended treatments for growths within the chest, both cancerous and benign. RATS can be used to remove tumours within the lung, including primary tumours and lung cancers, as well as metastases and benign tumours. 

RATS is also a treatment for conditions affecting organs in the chest, including the diaphragm and thymus. The procedure is recommended for myasthenia gravis, with the robot enabling removal of the entire thymus gland, and for treatment of hyperhidrosis with transection of the sympathetic chain. 

Excellence in robotic-assisted surgery 

The installation of the da Vinci Xi system used for RATS is the 6th da Vinci system within Guy’s and St Thomas’ NHS Trust’s hospitals, solidifying our consultants’ reputation as leaders in robotic-assisted surgery in the UK, with the most advanced technology for robotic surgery.  

Guy’s and St Thomas’ NHS Foundation Trust is now the UK’s largest robotic-assisted surgery centre, aligning with the Trust’s commitment to pioneering medical innovation and enhancing patient care. With our profits from our private patient services reinvested back into our NHS Trust, we’re proud to support innovation and cross-site collaboration for robotic-assisted surgeries. 

When to refer 

Patients requiring treatment for lung and chest cancer, as well as for myasthenia gravis, can be referred to our team of thoracic surgery specialists at Royal Brompton Hospital. Our team will assess each patient to determine whether RATS is their best option, or if they may benefit from another treatment instead, such as open thoracic surgery or VATS.