Technical Details of Uniportal VATS Lobectomies

One obvious condition to start performing uniportal VATS lobectomy is learn the technique and visit experienced centres doing this procedures. Previous experience in double port technique helps the learning but is insuficient for the success of the uniportal procedure. Coruña university hospital and Minimally Invasive Thoracic Surgery Unit both located in Coruña (Spain) are the pioneers centres and with more experience worldwide (http://www.videothoracoscopy.com) In this video we present the technical details to manage the vein and artery during single port upper lobectomies. The sequence for upper lobectomies is the same as that for conventional VATS, but we recommend dividing first the upper lobe truncus anterior when possible in order to facilitate the insertion of the staplers in the upper lobe vein. Coordination between surgeon and the assistant handling the camera is crucial. Single-incision VATS lobectomy follows the oncological principles of major pulmonary resections by VATS: individual dissection of veins, arteries and lobar bronchus, likewise complete mediastinal lymphadenectomy with a video-assisted thoracoscopic approach, with no rib spreading. The procedure is performed by video visualization. Although uniportal video-assisted thoracoscopic (VATS) lower lobectomy can be performed with conventional instruments, the use of specially adapted conventional material (such as instrumentation with both proximal and distal articulation) seems to be more fitted for successful single-incision lobectomy. Diego Gonzalez-Rivas, MD, FECTS Minimally Invasive Thoracic Surgery Unit (UCTMI) and Coruña University Hospital, Coruña, Spain