A 2.5 cm anterior incision and a 12 mm subxiphoid port to perform a left lower VATS lobectomy: an attempt to improve uniportal VATS technique

Abstract

Uniportal Video-Assisted Thoracoscopic Surgery (UVATS) lobectomy is now performed all around the world and considered safe and feasible. We are going to share a new video-assisted-thoracoscopic technique for left lower lobectomy, an attempt to improve the postoperative outcomes of UVATS. A 72-year-old patient underwent VATS left lower lobectomy for a primary non-small cell lung cancer (NSCLC). Our patient had no perioperative complications and was then discharged to his home on postoperative day 3. The patient’s pain was managed with a paravertebral catheter during the first 24 hours and then with oral analgesics. Pathology report: well-differentiated adenocarcinoma; the size of the tumour was 3.3 cm; all margins were negative for residual tumour. The patient did not require adjuvant treatment. The new described technique can be easily performed by all the surgeons who have mastered the necessary skills to realize a UVATS lobectomy. Using subxiphoid port for stapler, for removal of the specimen, and for placement of the drainage could decrease postoperative pain with respect to UVATS lobectomy.