The place for minimally invasive surgery in extended resections for lung cancer in the management of T4 disease

With the newly emerging interest of minimally invasive surgery in thoracic surgery specialty, more surgeons are skilled enough to try to perform minimally invasive surgery for advanced stages of lung cancer that was formerly deemed as inoperable. This is derived from more interest by the community to ask for less invasive operations and speedy recoveries. Fears about safety, technical feasibility, and oncologic equality to the conventional, open resections are still not fully covered. Surgical options in those cases should be considered if patients have acceptable pulmonary and cardiac performance status with minimal comorbidities. A surgeon is morally certain that all known diseases can be removed, and that conversions should be considered as a safety approach during the operation if needed and not viewed as a failure.