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. 2014 Oct;6(Suppl 6):S674-81.
doi: 10.3978/j.issn.2072-1439.2014.09.17.

Uniportal video-assisted thoracoscopic sleeve lobectomy and other complex resections

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

Uniportal video-assisted thoracoscopic sleeve lobectomy and other complex resections

Diego Gonzalez-Rivas et al. J Thorac Dis. 2014 Oct.

Abstract

Thanks to the recent improvements in thoracoscopy, a great deal of complex lung resections can be performed without performing thoracotomies. During the last years, experience gained through video-assisted thoracoscopic techniques, enhancement of the surgical instruments and improvement of high definition cameras have been the greatest advances. The huge number of surgical videos posting on specialized websites, live surgery events and experimental courses has contributed to the rapid learning of minimally invasive surgery during the last years. Nowadays, complex resections, such as post chemo-radiotherapy resections, lobectomies with chest wall resection, bronchial and vascular sleeves are being performed by thoracoscopic approach in experienced centers. Additionally, surgery has evolved regarding the thoracoscopic surgical approach, allowing us to perform these difficult procedures by means of a small single incision, with excellent postoperative results.

Keywords: Sleeve lobectomy; bronchial anastomosis; bronchoplasty; single-port lobectomy; uniportal VATS.

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Figures

Figure 1
Figure 1
Surgical image of instrumentation during sleeve procedures.
Figure 2
Figure 2
Technique for knot pushing through a single port (6). Available online: http://www.asvide.com/articles/352
Figure 3
Figure 3
Simple bronchoplasty (7). Available online: http://www.asvide.com/articles/353
Figure 4
Figure 4
Drawing showing wedge bronchoplasty.
Figure 5
Figure 5
Wedge bronchoplasty (8). Available online: http://www.asvide.com/articles/354
Figure 6
Figure 6
Drawing showing sleeve bronchoplasty.
Figure 7
Figure 7
Sleeve bronchoplasty (9). Available online: http://www.asvide.com/articles/355
Figure 8
Figure 8
Surgical image of left lower sleeve anastomosis (main bronchus to left upper bronchus).
Figure 9
Figure 9
Sleeve segmental bronchoplasty (10). Available online: http://www.asvide.com/articles/356
Figure 10
Figure 10
Surgical image of instrumentation during right vascular reconstruction.
Figure 11
Figure 11
Vascular reconstruction (12). Available online: http://www.asvide.com/articles/357
Figure 12
Figure 12
Sleeve end to end vascular anastomosis (13). Available online: http://www.asvide.com/articles/358
Figure 13
Figure 13
Surgical image of double bronchovascular procedure.
Figure 14
Figure 14
Superior sulcus tumor (15). Available online: http://www.asvide.com/articles/359
Figure 15
Figure 15
Lower lobectomy with chest wall resection (17). Available online: http://www.asvide.com/articles/360
Figure 16
Figure 16
Nodule resection in a patient with contralateral pneumonectomy (18). Available online: http://www.asvide.com/articles/361
See this image and copyright information in PMC

References

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    1. Gonzalez-Rivas D, Fernandez R, Fieira E, et al. Uniportal video-assisted thoracoscopic bronchial sleeve lobectomy: first report. J Thorac Cardiovasc Surg 2013;145:1676-7. - PubMed
    1. Gonzalez-Rivas D, Delgado M, Fieira E, et al. Left lower sleeve lobectomy by uniportal video-assisted thoracoscopic approach. Interact Cardiovasc Thorac Surg 2014;18:237-9. - PMC - PubMed