Technique of uniportal VATS major pulmonary resections.
The surgical approach to lung resections is evolving constantly. Since the video-assisted thoracoscopic surgery (VATS) anatomic lobectomy for lung cancer was described two decades ago, many units have successfully adopted this technique. The VATS lobectomy can be defined as the individual dissection of veins, arteries and bronchus, with a mediastinal lymphadenectomy, using a videothoracoscopic approach visualized on screen and involving 2 to 4 incisions or ports, with no rib spreading. However, the surgery can be performed by only one incision with similar outcomes. Since 2010, when the uniportal approach was introduced for major pulmonary resections, the technique has been spreading worldwide. This technique provides a direct view of the target tissue. The parallel instrumentation achieved during the single-port approach mimics the maneuvers performed during open surgery. It represents a less invasive approach than the multiport technique, and minimizes the compression of the intercostal nerve. As the surgeon's experience with the uniportal VATS lobectomy grows, more complex cases can be performed by using this approach, thus expanding the indications for single-incision thoracoscopic lobectomy.
1 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 2 Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
Eva
E
Fieira Costa
1 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 2 Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
María
M
Delgado Roel
1 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 2 Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
Marina
M
Paradela de la Morena
1 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 2 Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
Diego
D
Gonzalez-Rivas
1 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 2 Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
Ricardo
R
Fernandez-Prado
1 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 2 Department of Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
Mercedes
M
de la Torre
Minimally invasive surgery; single-port lobectomy; uniportal video-assisted thoracic surgical resections; video-assisted thoracic surgery (VATS)