Single-port video-assisted thoracoscopic lobectomy with pulmonary artery reconstruction

Abstract

Despite the advances in video-assisted thoracoscopic surgery (VATS), vascular reconstruction of the pulmonary artery (PA) is still infrequently performed by thoracic surgeons because of the technical difficulties and the increased operative risk during thoracoscopy. The few published reports have been performed by using 3-4 incisions. We present the first report of a pulmonary artery reconstruction procedure performed by a single-incision VATS technique. A 73-year old male patient was operated on by the thoracoscopic approach through a single 4-cm incision with no rib spreading. The postoperative recovery was uneventful.

A glance at the history of uniportal video-assisted thoracic surgery

“…More challenging operations such as completion pneumonectomies, sleeve lobectomies, pulmonary resection after high doses of chemotherapy, vascular reconstructions are now successfully performed in advanced and selected centers. Since then, in quick and amazing succession, uniVATS very demolitive and reconstructive lung operations were reported by Diego Gonzalez-Rivas and his group (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46).…”

Overview of uniportal video-assisted thoracic surgery (VATS): past and present

“…Subsequently he has utilized this approach for even more complex resections: segmentectomy in 2012, pneumonectomy in 2012, bronchoplastic procedure in 2013, chest wall resection in 2013 and pulmonary artery reconstruction in 2013 (8)(9)(10)(11)(12).…”

Uniportal thoracoscopic surgery: from medical thoracoscopy to non-intubated uniportal video-assisted major pulmonary resections

“…Initially the technique was described only for lower lobes but it was rapidly improved and developed for upper lobes, segmentectomy and pneumonectomy (22)(23)(24)(25). In quick succession, more difficult cases were reported including bronchial sleeve resection, pulmonary artery resection and reconstruction, and then, in 2014, a double sleeve resection (26)(27)(28)(29)(30). As the uniportal approach was successfully applied to more and more complex cases, the contraindications for the uniportal approach changed.…”