Lung Cancer Surgery: VATS, Robotics and Lung-Preserving Technique

Devices like Novalung or ECMO are sometimes loosely called artificial lungs, but these are only a transition to tide a patient over, not a permanent solution. Xenotransplantation for lungs is not a reality and is still limited to animal labs, with no near-term prospect of harvesting an animal lung for human transplantation. What is genuinely advancing is ex vivo lung perfusion (EVLP), where a harvested lung is brought to a lab and optimised before transplant, this has meaningfully increased organ utilisation and allows transplant surgery to be done electively rather than only at odd hours, though it remains expensive even in Western countries.

Technology has made the world smaller, so practically everyone is living next door to expertise now. Any case can be raised by email or WhatsApp, with a response guaranteed within 24 hours, and the case can often be investigated or even treated locally with guidance if the necessary technology and facilities are available there. When the expertise or facilities are genuinely not available locally, the patient can then be brought to India, but sharing the case first, even just to check whether it meets the threshold for referral, is always the right first step.

Surgery isn't just about surgeon skill, it also depends on OT infrastructure and trained technical staff, and not everything required can be exported to run a camp abroad. A more practical model already in use is a structured online OPD: patient details and reports are shared in advance on an agreed schedule, and the African doctor partner, the Jivo team, and the Indian specialist jointly review the case and decide what can be treated locally versus what genuinely needs travel to India, with real patient satisfaction from this approach so far.

A large number of patients from various African countries have been treated, most commonly for bronchiectasis and various tumours of the lung and chest cavity, even without ever having personally visited Africa. For heart transplantation specifically, deceased-donor transplant is not possible for international patients under Indian law, so the more common referral for advanced heart failure from abroad is for an LVAD (left ventricular assist device), which has very good outcomes and has itself reduced overall demand for heart transplant.

Deceased-donor lung transplantation is not possible for international patients in India under current law, but in general, outcomes vary significantly by the underlying pathology, results are good for pulmonary hypertension, while outcomes for cystic fibrosis, bronchiectasis and other conditions vary by the individual disease process rather than following one single success rate.

Dissecting the lymph nodes first exposes the bronchovascular structures, making the subsequent lobectomy technically easier to perform with precision.

Sleeve resection removes the affected lobe and reconnects the remaining bronchus, avoiding a full pneumonectomy for centrally located tumours when clear margins can still be achieved, preserving more functioning lung.