title: Flexible videoscope for thoracoscopic lobectomy: evolution of uniportal technique.
abstract: BACKGROUND
  Over the years reducing the number of ports during Video-assisted thoracic surgery (VATS) has allowed to accomplish pulmonary lobectomy with a single incision. Endoscopic view and instruments maneuvers issues could be improved by using flexible endoscope. We report our experience of fifteen uniportal VATS (UVATS) using a flexible thoracoscope.
  
  
  METHODS
  A single incision of about 4-5 cm long was performed at the 5th intercostal space along the anterior axillary line. No additional skin incisions were made. A flexible videoscope and multiple VATS instruments were simultaneously inserted into the uniport. Pulmonary lobectomy with systematic mediastinal lymph node dissection was performed. Verbal pain scores were registered using the visual analog scale from 0 to 10 at the first post-operative day.
  
  
  RESULTS
  No post-operative complications or hospital mortality were recorded. Mean operative time was 112.6 min (range 70-200) and mean postoperative hospital stay 3.2 days (range 2-6). Mean pain score was 0.5 (range 0-2).
  
  
  CONCLUSIONS
  Single-incision VATS lobectomy using a flexible thoracoscope is a feasible and safe approach.
authors.affiliation: Division of Thoracic Surgery, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome "Sapienza", Via di Grottarossa 1035, 00189, Rome, Italy, mohsen.ibrahim@uniroma1.it.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ibrahim
authors.forename: Cecilia
authors.initials: C
authors.lastname: Menna
authors.forename: Claudio
authors.initials: C
authors.lastname: Andreetti
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Andrilli
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ciccone
authors.forename: Giulio
authors.initials: G
authors.lastname: Maurizi
authors.forename: Francesco
authors.initials: F
authors.lastname: Cassiano
authors.forename: Erino Angelo
authors.initials: EA
authors.lastname: Rendina
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D061646:Operative Time; D011013:Pneumonectomy / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation / Q000379:methods*; D020708:Thoracoscopes