The nature of thoracic surgery has seen a dramatic change over the last few decades with the introduction of minimally invasive techniques such as video assisted thoracoscopy. Recently, the use of robotic surgery has gained increasing popularity as an innovative technique. Its main advantages over a VATS approach include improved optics with 3-dimensioal imaging, improved dexterity and degrees of movement and a reduction of physiological tremors. However, its main criticisms have largely been focused on its high costs, both in terms of initial outlay as well as maintenance costs. In this chapter we explore and compare the financial implications of robotic surgery with the widely accepted VATS programme and its economic feasibility going forward.