Content verified by
What is RATS?
Robotic-Assisted Thoracic Surgery (RATS) is a type of minimally invasive surgery used to treat conditions inside the chest, including the lungs, diaphragm, and thymus gland.
It is performed using the da Vinci Xi robotic system, which allows our surgeons to operate through small incisions with improved precision, using robotic arms controlled entirely by the surgeon.
At Royal Brompton Hospital, RATS is offered as part of our advanced thoracic surgery service. This state-of-the-art technology allows our team to carry out complex procedures with greater accuracy, less pain, and faster recovery times compared to traditional open surgery.
Experts in robotic-assisted thoracic surgery
Our consultants offer:
- short-notice appointments, available in as little as 24 hours
- minimally invasive lung cancer treatments
- treatment for a wide range of conditions
Who might need RATS?
RATS may be recommended for patients who need surgery to treat a condition inside the chest. This includes:
- benign and cancerous tumours in the chest, including lung cancer
- hyperhidrosis (excessive sweating, treated by targeting nerves in the chest)
- myasthenia gravis (a condition affecting the nerves and muscles)
- repair of paralysed or ruptured diaphragm
- tumours of the thymus gland
Our consultant will assess your condition to decide if RATS is the best treatment option for you. In some cases, another surgical approach – like open surgery or video-assisted thoracoscopic surgery (VATS) – may be more appropriate.
How is RATS performed?
RATS is carried out under general anaesthetic. This means you will be asleep during the procedure.
Our surgeons will make 3 to 5 small cuts (usually 8–12 mm in size) in your chest wall. Through these incisions, the robotic arms are inserted. These arms hold miniature surgical instruments and a 3D camera.
Our surgeon controls the robotic system from a nearby console in the operating theatre. The robot does not operate independently – every movement is guided by the surgeon’s hands, with the system mimicking those movements in real time.
The high-definition 3D camera gives the surgeon a clear, magnified view of the chest, helping them to perform delicate procedures with great precision.
Once the surgery is complete, a small chest drain is usually inserted to help remove any excess fluid or air.
Frequently asked questions (FAQs)
Before your procedure, you will be invited for a pre-assessment appointment. During this visit, our consultant will review your medical history, and our team may carry out blood tests and scans if required.
You will also receive information about fasting, medications, and what to bring on the day of surgery. Your care team will explain the procedure and answer any questions you may have.
The length of the operation varies depending on the complexity of the condition being treated, although with experienced surgeons, RATS can be a quicker method than open surgery, and typically takes 2-3 hours.
Our surgical team will let you know what to expect based on your specific case.
One of the main advantages of RATS is a quicker recovery compared to open surgery. Most patients:
- spend fewer days in hospital
- experience less pain after surgery
- are less likely to require strong painkillers (such as opiates)
- are able to return to normal activities sooner
Our team will provide a tailored recovery plan and follow-up care after you go home.
What are the benefits?
RATS offers several benefits over traditional open thoracic surgery, and is particularly suitable for older patients who may struggle with the longer, more intense recovery associated with open surgery.
The benefits of RATS include:
- faster recovery time
- improved access and precision for complex surgeries
- lower risk of bleeding
- no need for rib spreading
- reduced pain after surgery
- shorter hospital stays
- smaller incisions and minimal scarring
What are the risks?
As with all surgery, RATS carries some risks. These may include:
- air leak from the lungs
- bleeding
- conversion to open surgery if complications arise
- infection
- reactions to anaesthetic
Our surgeon will discuss these risks with you and answer any questions before the operation.
If you would like to speak to one of our thoracic surgeons about the benefits and risks of RATS, and alternative thoracic surgery options, contact us to book an appointment.
Locations
Our private thoracic surgery services are located at:
Discover our thoracic surgeons
Our world-leading thoracic surgeons can perform a range of surgeries, including innovative robotic-assisted procedures. We are experts in complex thoracic surgery.