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. 2016 Mar 14:2:45.
doi: 10.21037/jovs.2016.02.18. eCollection 2016.

Technical steps in single port video-assisted thoracoscopic surgery lobectomy

Benedetta Bedetti  1 , Marco Scarci  1 , Diego Gonzalez-Rivas  2
Affiliations

Technical steps in single port video-assisted thoracoscopic surgery lobectomy

Benedetta Bedetti et al. J Vis Surg. .

Abstract

Video-assisted thoracoscopic surgery (VATS) has transformed the way of treating patients with lung diseases over the past two decades and this is particularly true referred to patients with lung carcinoma. The indication for surgical treatment could be extended to those patients that were functionally unable to receive a thoracotomy and overall this approach shortened the length of stay in hospital and improved the quality of life of these patients postoperatively. The best VATS technique for lobectomy has not been well defined yet. The VATS approach to lobectomy can be performed via 1-4 incisions without rib spreading with similar outcomes. Over the last few years the single port VATS approach has generated a growing interest in the scientific thoracic surgery community as less invasive for the patients and comfortable for the performing surgeon. The aim of this video-article is to show the different steps of this technique and to provide some tips and tricks to improve and facilitate the execution of the uniportal VATS lobectomy.

Keywords: Uniportal video-assisted thoracoscopic lobectomy; single port minimally invasive thoracic surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Specific adapted instrumentation with distal articulation and articulated staplers.
Figure 2
Figure 2
Dissection of the fissure and of the lower lobe pulmonary artery using the Harmonic® Unltrasonic Device (9). Available online: http://www.asvide.com/articles/843
Figure 3
Figure 3
Incision in the 5th intercostal space anterior axillary line (12). Available online: http://www.asvide.com/articles/844
Figure 4
Figure 4
Use of 45º applier for polymer clips to divide the vessels (13). Available online: http://www.asvide.com/articles/845
Figure 5
Figure 5
Use of the stapler to avoid traction (14). Available online: http://www.asvide.com/articles/846
Figure 6
Figure 6
Difficult bronchus dissection during left upper lobectomy (15). Available online: http://www.asvide.com/articles/847
Figure 7
Figure 7
Division of the anterior portion of major fissure and of the main for the middle lobe (16). Available online: http://www.asvide.com/articles/848
Figure 8
Figure 8
Fissureless technique in left lower lobectomy (17). Available online: http://www.asvide.com/articles/849
Figure 9
Figure 9
Dissection on the paratracheal lymph nodes (18). Available online: http://www.asvide.com/articles/850
Figure 10
Figure 10
Dissection of the superior pulmonary vein using the curved sucker (22). Available online: http://www.asvide.com/articles/851
See this image and copyright information in PMC

References

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