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Case Reports
. 2013 Aug;5 Suppl 3(Suppl 3):S246-52.
doi: 10.3978/j.issn.2072-1439.2013.07.44.

Uniportal video-assisted thoracoscopic pneumonectomy

Diego Gonzalez-Rivas  1 , Maria Delgado, Eva Fieira, Lucía Mendez, Ricardo Fernandez, Mercedes de la Torre
Affiliations
Case Reports

Uniportal video-assisted thoracoscopic pneumonectomy

Diego Gonzalez-Rivas et al. J Thorac Dis. 2013 Aug.

Abstract

Video-assisted thoracoscopic surgery (VATS) was introduced nearly 2 decades ago and has experienced an exponential increase for lung cancer treatment. A pneumonectomy can be performed by video-assisted thoracoscopic surgery and the lung usually fits through the incision as usually used for VATS lobectomy. The most common approach for pneumonectomy is undertaken with 3 or 4 incisions, including a utility incision of about 3-6 cm. However, this resection is amenable by using only a single utility-incision. This chapter describes the technique for pneumonectomies by single-incision thoracoscopic approach with no rib spreading.

Keywords: Video-assisted thoracoscopic surgery (VATS); completion pneumonectomy; intrapericardial pneumonectomy; left pneumonectomy; right pneumonectomy.

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Figures

Figure 1
Figure 1
Incision on the right side.
Figure 2
Figure 2
Instrumentation during right pneumonectomy.
Video 1
Video 1
Right pneumonectomy (part 1).
Video 2
Video 2
Right pneumonectomy (part 2).
Figure 3
Figure 3
Postoperative result of right pneumonectomy with chest tube placed in the posterior part of the incision.
Figure 4
Figure 4
Chest tube placed through additional incision in case of big tumors removed by using rib spreader (left pneumonectomy, 12 cm tumor).
Figure 5
Figure 5
Aortopulmonary lymph node removal.
Figure 6
Figure 6
Division of left main pulmonary artery.
Video 3
Video 3
Division of left main pulmonary artery by using a endostapler.
Video 4
Video 4
Division of left inferior pulmonary vein.
Figure 7
Figure 7
Use of TA 30 linear stapler to transect the left main bronchus.
Video 5
Video 5
Transection of lef main bronchus by using a TA 30 linear stapler.
Figure 8
Figure 8
Single chest tube placed in the posterior portion of the left incision.
Video 6
Video 6
Left intrapericardic pneumonectomy after induction treatment.
Video 7
Video 7
Left pneumonectomy in two steps: lower and upper lobectomy.
Video 8
Video 8
Completion pneumonectomy: right lower lobectomy after induction chemotherapy (previous bilobectomy).
Figure 9
Figure 9
Instrumentation for completion pneumonectomy.
See this image and copyright information in PMC

References

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    1. McKenna RJ, Jr, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg 2006;81:421-5; discussion 425-6 - PubMed

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