Single-staged uniportal VATS in the supine position for simultaneous bilateral primary spontaneous pneumothorax

Abstract

BackgroundSimultaneous bilateral primary spontaneous pneumothorax (SBPSP) is rare, but requires surgery on both sides, in patients with definite bilateral bullae to prevent life-threatening conditions. Recently, uniportal video-assisted thoracoscopic surgery (VATS) has been widely accepted as a less invasive technique for the treatment of pneumothorax. Thus, we introduced single-staged uniportal VATS technique in the supine position, for the management of two cases of SBPSP.Case presentationA 17-year-old boy presented with bilateral spontaneous pneumothorax and he underwent single-staged uniportal VATS in the supine position. Single wide draping in consecutive bilateral approaches removes the needs of changing patients’ position. Whole thoracoscopic procedure for wedge resection of bullae lesions was conducted without difficulty. The total operation time took 65 min and the patient discharged 3 days after the operation. The patient was followed for 24 months without recurrence of both sides. Another 18-year-old boy was admitted with bilateral spontaneous pneumothorax and single-staged uniportal VATS was also performed in the supine position. The total operation time took 79 min and the patient discharged on postoperative day 4. He was followed for 19 months without recurrence of both sides.ConclusionsSingle-staged uniportal VATS approach yielded satisfactory results from simplicity that not requires position change compared to conventional multi-ports VATS in the lateral position, and with better cosmetics. This technique is thought to be a feasible procedure in selective patients with SBPSP or with contralateral bullae for preventive role.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-017-0591-7) contains supplementary material, which is available to authorized users.

Uniportal vs. triportal video-assisted thoracic surgery in the treatment of primary pneumothorax—a propensity matched bicentric study

“…In the last years few reports evaluated the efficacy of U-VATS in the treatment of primary PNX; most of them were either retrospective, monocentric and unfocused works that often yielded to conflicting results (13). While some authors reported better postoperative outcomes in terms of operative time, blood loss, postoperative pain (13)(14)(15)(16), others didn't (17). Moreover authors experienced limitations in surgical exposure and technical difficulties in performing U-VATS rather than in three port VATS (18).…”

Simultaneous Bilateral Primary Spontaneous Pneumothorax (SBPSP) in a young male athlete: A rare presentation

“…A history and thorough physical examination are helpful to detect pneumothorax, CXR or chest ultrasound take part in evaluation. A unique radiographic feature of the CXR is accumulation of gas between pleural layers (Kim, 2017). Acute breathlessness, chest discomfort, and decreased breath sounds are common signs and symptoms.…”

Polyglycolic acid sheet with fibrin glue technique without pleural abrasion in uniportal VATS for primary spontaneous pneumothorax

“…Under general anesthesia with double-lumen endotracheal tube intubation for selective one-lung ventilation, the patient was placed in the lateral or semi-lateral decubitus position for the ipsilateral approach and the supine position for a bilateral approach (6). A minimal skin incision (1.5-2.5 cm in length) was created in the fourth or fifth intercostal space in the anterior to middle axillary line.…”