Subxiphoid uniportal video-assisted thoracoscopic middle lobectomy and anterior anatomic segmentectomy (S3)

Abstract

The video-assisted thoracoscopic surgery (VATS) approach for combined lobectomy and segmentectomy in the same lung is an infrequent procedure, rarely reported in the literature. Currently, Most of the surgeons still use 2-3 thoracic incisions for thoracoscopic anatomic resections. However, the uniportal approach is gaining worldwide acceptance in the recent years. The main advances of uniportal VATS during the last years are related to improvements in surgical technique by implementing new technology. The experience acquired with the uniportal technique allows expert uniportal VATS surgeons to explore new approaches in order to minimize even more the surgical invasiveness. Recently the aim to avoid the intercostal nerve damage created by the transthoracic incision has led to the creation of a novel procedure entitled uniportal VATS subxiphoid approach. Here we report the first case of a lobectomy combined with anatomic segmentectomy performed through a uniportal subxiphoid approach.

Keywords: Subxiphoid approach; lobectomy; segmentectomy; uniportal VATS; uniportal subxiphoid.

Figure 1

CT scan showing the GGO lesions located on the middle lobe (A) and on the anterior segment of the right upper lobe (B).

Figure 2

Subxiphoid uniportal video-assisthed thoracoscopic middle lobectomy and anterior anatomic segmentectomy (10). Available online: http://www.asvide.com/articles/904

Figure 3

Surgical photo showing bimanual instrumentation through the subxiphoid incision.