Royal College of Physicians –
London, UK
Friday, October 20, 2017
While around 100 thoracic surgeons are gathered here this morning for the start of the 4th VATS International conference, there are another 500 viewers watching Dr. Eric Lim (UK) deliver his opening remarks on a live stream video feed on CTSnet.org.
Dr. Lim, who is one of the dynamic young thoracic surgeons leading the charge into minimally invasive thoracic surgery (MITS) reviews the state of the current evidence VATS and other MITS techniques, and the role of research in advancing thoracic surgery. Today’s lecture is delivered in a more measured, and calculated manner in comparison to his more fiery orations in the past – but the message remains the same: Surgeons need to remain engaged and participate in the research because if we don’t, and if we continue to stay in the operating room while other specialties define the outcomes, than we (and our patients) will continue to be short-changed by competing specialties.
0900 – 2017-10 Current and future research topics – Lim (International VATS symposium)

While the conference started off with a call to research – once the topic of robotic -assisted thoracic surgery (RATS) was introduced, it wasn’t long before there was a quick shot across the bow.
Dr. Piergiorgio Solli (Italy) was delivering a well-thought out review of the current literature of RATS with the question: Why are they using robotics (despite a lack of evidence?)
0940 – Piergiorgio Solli VATS versus RATS

He was cut short in his review by the American surgeon, Dr. Robert Cerfolio. Dr. Cerfolio, the ‘Gordon Gekko’ of thoracic surgery, and world-reknown RATS surgeon took that moment to issue a challenge to the podium, “and how many robotic surgeries have you done?” He then continued to defend the use of RATS stating that using RATS was like buying expensive luxury items (tailored suits, custom shoes, first -class airline tickets, etc.) by stating, “It costs more money because it’s good”

That was all that it took for Dr. Lim to enter back into the fray, asking ,”Is it one million [dollars] good?” (referring to the excessive start up and operating costs).
Cerfolio: “It costs more because it’s better” stated the self-proclaimed surgeon of the industry. “You don’t know it’s better because you haven’t done enough.”
The gloves are off my friends. Welcome to the 4th session of VATS International.
I followed the livestreaming. That debate was tremendous.I liked it and learned a lot