Abstract
There is continued interest in finding an optimal approach for thoracic surgery. The intercostal space has been accepted as the standard route for video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS). However, the intercostal approach causes postoperative chronic pain and related complications due to intercostal nerve injury. To overcome the shortcomings of the intercostal approach, the subcostal VATS has been proposed.1 However, the long distance from the costal arch to the hilum and the interference from the hip and abdomen make this procedure difficult.
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