The Use of Single Incision Thoracoscopic Surgery in Diagnostic and Therapeutic Thoracic Surgical Procedures

Abstract

Background : As a minimal invasive procedure, a standard threeportal videothoracoscopy may have complications such as chronic and residual pain. However, a single incision thoracoscopic surgery is a less invasive procedure with minimal complications. We present our series of patients who had single incision thoracoscopic surgical procedures.Patients and methods : A total of 49 patients, 29 (59.2%) male and 20 (40.8%) female with a mean age of 45.7 ± 17.6 years (range, 16 to 86 years) underwent a total of 59 single incision thoracoscopic surgical procedures. We most often made a 2–2.5 cm single incision on the seventh or eighth intercostal space at the midaxillary line. VAS (Visual analogue scale) scores for pain at postoperative day 1 and the mean of chest tube removal times were recorded for each procedure. The patients were discharged following chest tube removal.Results : We performed an overall of 59 procedures including 8 (13.7%) wedge resections for either histologic diagnosis or spontaneous pneumothorax, 4 (6.8%) pleural biopsies, 23 (38.9%) pleurectomies, 9 (15.2%) deloculation and decortications, 5 (8.6%) traumas in and 10 (17.5%) sympathectomies. No patient required an additional thoracoscopic port or conversion to thoracotomy. The overall mean of postoperative VAS scores for all procedures at postoperative day 1 and day 30 were 3.2 ± 0.9 and 1.4 ± 0.5, respectively (p < 0.0001). The overall mean of chest tube removal time was 2.3 ± 0.8 days (median; 2). We observed neither morbidity nor mortality.Conclusions : In selected patients, single incision thoracoscopic surgery is an effective and a safe procedure with lower levels of pain and shorter hospital stay. A wide spectrum of thoracic surgical procedures can be performed with the use of single incision thoracoscopic surgery.