Abstract
Although video-assisted thoracic surgery (VATS) has been in existence for more than a decade, the application of VATS to major pulmonary resections is still not widely practiced. This may simply reflect the fact that many surgeons may still perceive this operation to be technically demanding. By resecting a segment of rib underneath the utility minithoracotomy (without rib spreading), the surgeon can perform difficult VATS cases safely and easily with conventional thoracic instruments. We have found this a very useful approach in difficult VATS cases.
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