The objective of this study was to evaluate the safety and feasibility of robot-assisted thoracoscopic surgery (RATS).From May 2009 to May 2013, 48 patients with intrathoracic lesions underwent RATS with the da Vinci® Surgical System was reported (11 lobectomies, 37 mediastinal tumour resections).RATS was successfully and safely completed in all 48 patients. Conversion of the operation to open surgery was not needed in any patient. The average operation time was 85.9 min, average blood loss 33 ml, and average hospital stay 3.9 days. No patient required blood transfusion. The only recognized adverse event was the development of a bronchopleural fistula in one patient.RATS appears feasible and safe in thoracic surgery. More investigation will be needed in order to determine its possible long-term benefits and cost effectiveness.