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Robotic-assisted thoracic surgery - RATS, done properly.

Robotic lobectomy, segmentectomy, thymectomy and mediastinal resection. A named consultant thoracic surgeon at real RATS volume, a genuine MDT, and the honest comparison with VATS and open before you consent.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private RATS costs in the UK.

Indicative ranges across our partner thoracic units.

In short

£18,000–£28,000, home in 3–5 nights.

ProcedureIndicative range
Robotic wedge resection£12,000–£18,000
Robotic segmentectomy£15,000–£22,000
Robotic lobectomy£18,000–£28,000
Robotic thymectomy£14,000–£22,000
Robotic mediastinal mass resection£16,000–£26,000
Robotic pleural biopsy / decortication£10,000–£16,000
Consultant thoracic opinion£300–£500

Prices vary by hospital, by consultant, by the extent of nodal dissection and whether HDU is needed post-op. Complex mediastinal cases sit at the top of the range.

The problem

Not every lung operation should be robotic.

RATS is a genuine advance for the right patient. Where general thoracic services under-deliver: rushed VATS-vs-RATS decisions, thin pre-hab, and cursory MDT for private patients.

  • The right minimally invasive route

    Uniportal VATS, multi-port VATS and RATS all overlap. Match the operation to the surgeon’s highest-volume technique.

  • Pre-hab is not optional

    Two to four weeks of inspiratory training, walking and smoking cessation halves respiratory complications. We build it in.

  • A private MDT that actually meets

When it helps

Where RATS is the right tool.

The situations where the robot changes outcomes, plus the red flag that means open thoracotomy is safer.

  • Early-stage non-small-cell lung cancer

    Stage IA–IIA NSCLC where anatomical resection - segmentectomy or lobectomy - with node dissection is the operation of choice.

  • Central or hilar tumours

    Lesions close to hilar vessels where the wristed instruments and 3D view make dissection safer than VATS.

  • Complex mediastinal lymph-node dissection

    Systematic nodal sampling for staging accuracy - RATS reaches stations 7 and 4R more comfortably than straight-stick VATS.

  • Anterior mediastinal masses and thymoma

    Thymectomy for thymoma or myasthenia gravis - RATS is now the standard minimally invasive approach in many UK units.

  • Lung metastasectomy

    Wedge resection of pulmonary metastases from colorectal, sarcoma, renal or germ-cell primaries, planned with the oncologist.

  • Sympathectomy for hyperhidrosis

    Bilateral thoracic sympathectomy for severe palmar or facial sweating, where a robotic approach adds precision at the sympathetic chain.

  • Diaphragm plication and hernia repair

    Selected diaphragm operations where the robot’s reach into the costophrenic angle is helpful.

  • Red flag: bulky central tumours or emergencies

    Very central T4 tumours, massive haemoptysis or ruptured pathology still belong in an open thoracotomy - do not accept a robotic promise for these.

Procedure options

Approach and extent both depend on your CT.

RATS is one of several minimally invasive options - VATS variants and open thoracotomy still have their place.

  • RATS lobectomy

    The commonest robotic thoracic operation. Anatomical resection of one lobe with systematic nodal dissection. 2–4 hours, 3–5 nights.

  • RATS segmentectomy

    Sub-lobar anatomical resection - increasingly used for small (< 2 cm) peripheral NSCLC where lung preservation matters.

  • RATS wedge resection

    Non-anatomical resection for diagnostic biopsy of an indeterminate nodule, or for metastasectomy.

  • RATS thymectomy

    Removal of the thymus for thymoma, thymic cyst or myasthenia gravis. RATS is well-suited to the retrosternal anatomy.

  • Uniportal VATS

    Single-incision VATS remains highly competitive with RATS for peripheral resections - shorter theatre time, no platform fee.

  • Multi-port VATS

    The mature UK minimally invasive standard. RATS advantages narrow when the surgeon is a very high-volume VATS operator.

  • Open thoracotomy

    Still the right operation for very central T4 tumours, chest-wall involvement, extensive pleural symphysis, or emergencies.

  • Awake / non-intubated thoracic surgery

    A niche technique in selected UK centres - usually VATS rather than RATS at present.

Safety and recovery

What to expect afterwards - honestly.

RATS is well established. The things worth planning are pre-hab, one-lung ventilation tolerance, and the drain plan.

  • GA with one-lung ventilation

    A double-lumen tube collapses the operated lung. A thoracic anaesthetist is essential - glaucoma, severe COPD and pulmonary hypertension need extra planning.

  • Conversion to open thoracotomy

    Bleeding, dense pleural adhesions or unexpected central invasion may force conversion. It happens in 2–5 percent of experienced RATS cases and is a safety decision, not a failure.

  • Air leak and prolonged drain

    The commonest thing that delays discharge. Most seal by day two; a minority need suction or, rarely, a small procedure.

  • Chest infection and atelectasis

    Reduced by pre-hab, smoking cessation and effective pain relief that lets you cough. Take your incentive spirometer seriously.

  • Nerve injury

    Intercostal, phrenic or recurrent laryngeal nerve injury is uncommon; the wristed instruments and 3D view actually reduce this risk versus older techniques.

  • Pain and rib discomfort

    Port sites and drain tracks ache for 2–6 weeks. Paravertebral or epidural blocks help early days; simple analgesia and physio do the rest.

  • Return to activity

    Desk work at 2–3 weeks, driving when you can perform an emergency stop without pain (usually 3–4 weeks), heavy activity at 6–8 weeks.

  • Adjuvant treatment

    For proven cancer, chemotherapy or immunotherapy may follow at 4–8 weeks depending on histology and stage - decided at MDT.

  • Red flags after surgery

    Sudden breathlessness, chest pain, fever above 38.5, calf swelling or drain-site bleeding: same-day thoracic team or A&E.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever platform was used - da Vinci Xi is the UK standard for RATS - the note keeps to the same shape.

A UK consultant thoracic surgeon reviewing operation notes

A quiet reminder

Thoracic notes are dense - we translate them for you.

If you would like us to talk you through the operation note and the histology before your review, just ask.

  1. 01Header

    Approach, ports and console time

    RATS on which platform, number of ports, docking time, console time and blood loss.

  2. 02Technique

    Anatomy, fissure and vessels

    How the lobe was released, fissure completeness, vessel and bronchus stapling, and any adhesiolysis.

  3. 03Findings

    Nodes, margins and specimen

    Which node stations were sampled, macroscopic tumour findings, and once histology is back - pathological stage and margins.

  4. 04Impression

    Recovery targets, MDT and follow-up

    Read this first: drain plan, mobilisation, next MDT date, adjuvant plan and CT surveillance timeline.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

RATS is usually covered for approved indications after pre-authorisation.

Frequently asked

Everything we get asked about RATS.

Quick answers on RATS vs VATS, drains, cost, cover and recovery.

  • What is the difference between RATS and VATS?

    Both are minimally invasive lung operations. VATS uses straight instruments through small incisions with a 2D video view. RATS uses a robotic console - wristed instruments and true 3D vision. In experienced hands, oncological outcomes are comparable; RATS often wins on lymph-node yield, nerve preservation and surgeon ergonomics, especially for central tumours and mediastinal work.

  • Is RATS as safe as open thoracotomy for lung cancer?

    For appropriately selected patients - stage I to selected IIIA NSCLC - RATS lobectomy delivers equivalent cancer outcomes with less pain, shorter drain times, shorter hospital stay and faster return to activity than open thoracotomy. Very central T4 tumours, chest-wall invasion and emergency cases still favour open surgery.

  • How much does private robotic thoracic surgery cost in the UK?

    Roughly £12,000–£18,000 for a robotic wedge, £15,000–£22,000 for a segmentectomy, £18,000–£28,000 for a lobectomy and £14,000–£22,000 for a thymectomy. Full self-pay quotes include anaesthesia, HDU, chest drains and one follow-up. Insurance usually covers RATS for approved indications after pre-authorisation.

  • How long is the hospital stay after RATS lobectomy?

    Typically three to five nights. Drains often come out on day two, and most patients are home by day four. Enhanced-recovery pathways aim for earlier - but no one is discharged with a productive drain or breathless.

  • How long before I can drive, work and exercise again?

    Desk work at two to three weeks, driving usually at three to four weeks once you can do an emergency stop pain-free, and heavy activity or gym work at six to eight weeks. Anything requiring deep breathing or overhead lifting takes longest.

  • Do I need chemotherapy or immunotherapy after RATS?

    It depends on the pathological stage. Stage IA usually needs no adjuvant treatment. Stage IB–IIIA often benefits from adjuvant chemotherapy or, increasingly, immunotherapy such as osimertinib or atezolizumab. The MDT makes the call after full histology is back.

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