Quality of Lymph Node Dissection in Lung Cancer Surgery: A Comparative Analysis of Robotic‐Assisted Versus Video‐Assisted Thoracic Surgery Using Novel Pathological Criteria

Background Lymph node dissection is essential for lung cancer staging and treatment planning. This study compares the extent and quality of lymph node dissection between robot‐assisted thoracic surgery (RATS) and video‐assisted thoracic surgery (VATS). Methods In this prospective cohort study, 40 patients undergoing oncologic lobectomy via RATS ( n = 20) or VATS ( n = 20) were included. We assessed the number of explored lymph node stations, dissected nodes, and microscopic integrity criteria. Results RATS resulted in a higher median number of explored stations (5 vs. 4; p = 0.0375) and resected nodes (8 vs. 6; p = 0.0432). However, no significant differences were found in the microscopic quality criteria. Conclusions RATS enables broader lymph node dissection but does not improve microscopic quality compared with VATS. These findings highlight the need for further studies to assess clinical outcomes.