Video-assisted Thoracoscopic Surgery Technique Research Articles

Approach to mediastinal masses: a comparison of open surgery and uniportal video-assisted thoracoscopic surgery techniques

Aims: This study aimed to compare perioperative and postoperative outcomes in patients who underwent uniportal video-assisted thoracoscopic surgery (U-VATS) and open surgery for mediastinal mass resection. Methods: A total of 62 patients who underwent mediastinal mass resection in the Thoracic Surgery Clinic were included. The patients were separated into the open surgery group (n=30) and the U-VATS group (n=32). The groups were compared in terms of perioperative and postoperative outcomes including operative time, blood loss, chest tube removal time, drainage volume, pain, and hospital stay. Results: The distributions of age and gender were similar between the groups. Median operation time (120 vs. 180 minutes, P < 0.001), median intraoperative blood loss (50 vs. 100 mL, P < 0.001), median time of chest drain removal (4 vs. 6 days, P < 0.001) and median postoperative drainage volumes were lower in the U-VATS group than the open surgery group. The U-VATS group exhibited a lower VAS score, return time to daily activity (1 vs. 4 days, P < 0.001) and length of hospital stay (4 vs. 6 days, P < 0.001). A postoperative myasthenic crisis was not observed in all cases. One thymoma patient in the open surgery group had a recurrence, but not in the U-VATS group. Conclusion: The U-VATS approach had better intraoperative safety and lower postoperative outcomes than open surgery. U-VATS, which has the potential to enhance postoperative recovery and quality of life, may be a safe and effective treatment option for patients with mediastinal mass resection.

Modifications to the video-assisted thoracoscopic surgery technique reduce 1-year mortality and postoperative complications in intrathoracic tumors.

The purpose of the study is to analyze the immediate outcomes and results of video-assisted thoracoscopic lobectomy and lung resection performed in the surgical department of the AOC between 2014 and 2018. For the period from 2014 to 2018, 118 patients with peripheral lung cancer were operated on in the surgical department of the AOC. The following operations were performed: lobectomy in 92 cases (78%), of which: upper lobectomy, 44 (47.8%); average lobectomy, 13 (14.1%); lower lobectomy, 32 (35%); bilobectomy, 3 (3.3%). All patients underwent extensive lymphadenectomy on the side of the operation. In 22 patients, for various reasons, preservation of thoracotomy was performed. The absence of N0 lymph node damage was observed in 82 patients (70%), the first-order lymph node damage N1 in 13 (11%), N2 in 13 (11%), N3 in 5 (4%), and NX in 5 (4%). Histological examination revealed: squamous cell carcinoma - 35.1%, adenocarcinoma - 28.5%, undifferentiated carcinoma - 8.3%, NSCLC - 5.6%, NEO - 4.6%, sarcoma - 1.8%. At the same time, in 12.7% of patients, mts was detected - lung damage, and in 3.4%, malignant cells were not detected. Most patients were activated on the first day after surgery. An analysis of the direct results of the study allows us to conclude that video-assisted thoracoscopic surgery is a highly effective, minimally invasive, safe method for treating peripheral lung cancer, which allows us to recommend it for wider use in oncological practice.

Thoracoscopic treatment of primary spontaneous pneumothorax without a drainage tube in male patients

To propose a treatment approach for primary spontaneous pneumothorax (PSP) in male patients with a smaller incision and less pain. We retrospectively studied 29 patients with PSP who underwent areola-port video-assisted thoracoscopic surgery (VATS) and 21 patients who underwent single-port VATS. The areola-port VATS technique was performed as follows. First, an arc incision was made along the lower edge of the areola, and a 5-mm-diameter thoracoscope was placed. The bullae were completely removed, and the absence of air leaks and other bullae was confirmed. A drainage tube was placed in the chest with negative pressure and then quickly pulled out, and the reserved suture line was knotted. All patients were male, and their mean age was 19.07 ± 2.43 years. The mean intraoperative hemorrhage volume and postoperative pain score were significantly lower in the areola-port than single-port group. The mean operative time and mean postoperative hospital stay were also shorter in the areola-port group, but without statistical significance. The incidence of complications and the 1-year postoperative recurrence rate were 0% in both groups. Our method is clinically feasible and inexpensive, has a traceless effect, and is especially suitable for adolescents.

Short-Term Outcomes of Fiberoptic Bronchoscopy-guided Resection and Anastomosis Control in Thoracic Surgery.

In thoracic surgery practice, bronchial closure and anastomosis are relatively easy in technical terms; however, it is also the procedure that is most open to the development of complications with high morbidity. This study aimed to investigate the effect of simultaneous evaluation of bronchial closure under fiberoptic bronchoscopy guidance during lung resection on the development of complications. Patients aged over 18 years who underwent elective lung resection in our clinic between 2017 and 2021 were included in the study. Postoperative complications were recorded and statistically analyzed. The mean age of the patients was 61.4±10.4 years, and 267 patients were male (75.4%) and 87 (24.6%) were female. Thoracotomy was performed in 258 (72.9%) patients and lung resection with the video-assisted thoracoscopic surgery technique in 96 (27.1%) patients. During the follow-up, complications were observed during the first 30 days in 78 (22.0%) of the patients and later in 9 (2.5%). Surgical mortality occurred in 11 patients (3.1%), and the rate of readmission to the intensive care unit was 5.6% (n=20). We consider that the control of the resection line with the active use of fiberoptic bronchoscopy during surgery is important for the prevention of the development of bronchial morbidity. Complications in the early period can be reduced by ensuring that the remaining bronchus is not narrowed, there are no residual stump structures that may disrupt the bronchial line, such as cartilage, and bronchial washing is frequently undertaken.

Uniport video-assisted thoracoscopic surgery for thoracic Eden type IV dumbbell tumor.

Uniport video-assisted thoracoscopic surgery for thoracic Eden type IV dumbbell tumor.

Uniportal VATS Pleural Biopsy: Analysis of 50 Cases Is It Safe and Effective ?

Objective: Pleural effusion may occur in patients due to benign or malignant processes. This study aimed to evaluate the efficacy and safety of Uniportal Video-Assisted Thoracoscopic Surgery (VATS) operation in the diagnosis processes of patients with pleural effusion.Methods: The data of 50 patients who underwent diagnostic Uniportal VATS pleural biopsy between November 2018 and April 2021 were retrospectively analyzed. The patients' age, gender, postoperative hospital stay, operation-related complications, and pathology results of the pleural tissues were recorded.Results: Thirty-five (70%) cases were male, 15 (30%) were female, mean age was 52.58 ± 20.1, mean operative time was 56.1 ± 16.8 minutes, and mean postoperative hospital stay was 2.64 ± 0.89 days. 48 (96%) of the patients were operated on under general anesthesia and 2 (4%) under sedative anesthesia. All patients were operated on with the Uniportal VATS technique. The postoperative treatment process was carried out with service follow-up without requiring intensive care follow-up. Twenty-eight (56%) patients were operated on from the right and 22 (44%) patients from the left hemithorax. When the pleural biopsy results were examined, malignancy was detected in 18 (36%) patients and tuberculosis in 8 (16%). Malignancies: 6 were adenocancer metastases (2 stomachs, 2 breast, and 2 colon cancers), 5 malignant mesotheliomas, 4 epidermoid cancer metastases (2 ovarian and 1 breast and 1 malignant melanoma), 2 lung adenocarcinoma infiltration, and 1 chondrosarcoma metastasis. No postoperative complications were observed in any of the patients.Conclusion: Uniportal VATS is an easy-to-apply, safe, effective, and rapid method for diagnosing pleural effusion.

The 12 steps to a thoracoscopic anterior segment segmentectomy: Oncologically safe and sound.

The 12 steps to a thoracoscopic anterior segment segmentectomy: Oncologically safe and sound.

КИСТОЗНАЯ ГАМАРТОМА ЛЕГКОГО, РАСЦЕНЕННАЯ КАК СПОНТАННЫЙ ПНЕВМОТОРАКС

Cystic hamartoma refers to rare benign lung tumors. The literature describes 17 cases of this disease. The tumor may look like multiple bilateral cysts or a solitary single-chamber or multi-chamber cyst of a large size, which makes it difficult to diagnose. The disease can be complicated by spontaneous pneumothorax. The cyst itself often looks like a pneumothorax. An observation of a 52-year-old man complaining of chest pain and shortness of breath is presents. On the x-ray, the left lung is compressed with air, which is regarded as a spontaneous pneumothorax. Two-day drainage did not give any results. The video-assisted thoracoscopic surgery technique was performed and a large air cyst was detected. A conversion to a thoracotomy was made. A cyst of 20×15 cm size originated from the lower lobe, the lung was in atelectasis. Cyst resection and lung decortication were performed. Histological examination of the cyst wall revealed a hamartoma of the lung. The postoperative period was uneventful. Differential diagnosis of cystic hamartoma is conducting with lymphangioleiomyomatosis, air cysts, extrapulmonary sequestration, echinococcal cysts, and lung cancer. Indications for surgery are the following: chest pain, shortness of breath, pneumothorax, and hemoptysis. In a unilateral process, a cyst resection or lobectomy have to be performed. Cystic pulmonary hamartoma should be included in the differential diagnostic range in patients with recurrent spontaneous pneumothorax, hemoptysis, single and multiple lung cysts. It is impossible to determine the diagnosis without a biopsy and histological examination.

Video-Assisted Thoracic Surgery Intrathoracic Anastomosis Technique.

The extracorporeal anastomosis technique for video-assisted thoracoscopic surgery (VATS) intrathoracic esophagogastric anastomosis is a convenient, easy technique to use in VATS esophagectomy. The surgeon can assess the viability and the status of the gastric conduit, and the introduction of a circular stapler can be easily done under direct vision extracorporeally, enabling easy and simple VATS intrathoracic anastomosis between the esophagus and the gastric conduit.

THE BENEFIT OF VATS ON THE IMPACT OF SMOKING AND RECENT CESSATION ON 30-DAY OUTCOMES IN LOBECTOMY FOR CANCER IN VETERANS

SESSION TITLE: Cardiothoracic Surgery Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Recent research has shown that smoking cessation as soon as two weeks prior to lobectomy for lung cancer results in lower odds of pulmonary complications relative to active smoking at the time of surgery. The increasing use of video-assisted thoracoscopic surgery (VATS) has reduced postoperative complications, but the effect of VATS on active smokers and recent quitters has not been investigated. The purpose of this study was to determine whether the use of VATS mitigates the negative effects of tobacco use on 30-day postoperative outcomes. METHODS: Patients who underwent VATS lobectomy for lung cancer at Veterans Health Administration (VHA) centers from 2012-2018 were retrospectively identified in the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. The sample was stratified into 3 groups: smokers within 2 weeks of surgery (“active smokers”), those who quit between 2 weeks to 3 months prior to surgery (“recent quitters”), and those who had not smoked in 1 year or longer (“non-smokers”). Multivariable analysis was used to compare groups after adjusting for covariates. RESULTS: Of 2,814 patients who met inclusion criteria, 1,351 were non-smokers, 395 were recent quitters, and 1,068 were active smokers. Compared to recent quitters, active smokers were significantly more likely to be reintubated (adjusted odds ratio (aOR) of 2.53, 95% confidence interval (CI) 1.05 – 6.06, p=0.04); however, there was no difference when pulmonary composite (including prolonged intubation, pneumonia, and reintubation) and complication rates of other organ systems were compared. Compared to non-smokers, active smokers were more likely to suffer pulmonary complications (aOR=1.58, CI 1.12 – 2.23, p=0.01), overall complications (aOR=1.43, CI 1.06 – 1.92, p=0.02), renal complications (aOR=3.91, CI 1.10 – 13.98, p=0.04) and infectious complications (aOR=2.07, CI 1.12 – 3.83, p=0.02). There were no differences in morbidity between recent quitters and non-smokers. CONCLUSIONS: In spite of previous evidence that smoking cessation has a significant impact on pulmonary complications after lung resection, this analysis demonstrates that the use of VATS technique appears to mitigate the difference in risk of morbidity between patients who are active smokers at the time of surgery compared to recent quitters. This distinction may be the result of the established benefits of minimally invasive techniques for lobectomy. Despite the demonstrated advantages of VATS, the likelihood of suffering from complications – both pulmonary and otherwise – is still significantly higher in active smokers compared to non-smokers. CLINICAL IMPLICATIONS: In addition to the other recognized benefits of VATS for lobectomy in lung cancer, this approach may lessen the adverse effects of smoking on postoperative outcomes. Despite improved operative techniques, smoking cessation is still imperative in reducing pulmonary complications. DISCLOSURES: No relevant relationships by Jared Antevil, source=Web Response No relevant relationships by Michael Napolitano, source=Web Response No relevant relationships by Ethan Rosenfeld, source=Web Response No relevant relationships by Andrew Sparks, source=Web Response No relevant relationships by Gregory Trachiotis, source=Web Response

Comparison of single-port vs. two-port VATS technique for primary spontaneous pneumothorax

Background Video-assisted thoracoscopic surgery (VATS) has been used for thoracic surgery for about two decades. As the trend in VATS is to use fewer ports to decrease postoperative complications, we compared the results of our experience with single-port and two-port VATS for primary spontaneous pneumothorax (PSP). Material and methods This is a non-randomized retrospective study. From January 2017 to December 2018, 104 patients with PSP underwent VATS. Fifty-six patients received single-port VATS and 48 patients received two-port VATS. Operation time, blood loss, number of staplers used, drainage time, postoperative hospital stay, complications, chest wall paresthesia, visual analog scale (VAS) pain scores, and patient satisfaction scale scores were compared between the two groups. Results There was no difference in age, gender, body mass index (BMI), smoking status, surgical indication, and involved side between the two groups. The procedures performed in the single-port group were similar to those performed in the two-port group. No significant difference was found in operation time, blood loss, number of staplers used, drainage time, and recurrence rate. The rate of chest wall paresthesia was lower in the single-port group than in the two-port group (28.6 vs. 52.1%, p = .014). The VAS scores in the single-port group were lower than those in the two-port group at 24 and 48 h (p = .032 and p = .004). Conclusions Compared with two-port VATS, single-port VATS for PSP showed more favorable results in terms of postoperative paresthesia and pain. The single-port procedure may be considered a good alternative to the standard thoracoscopic treatment of PSP. Abbreviations: VATS: Video-assisted thoracic surgery; PSP: primary spontaneous pneumothorax

Pulmonary Lipoma in an Atypical Location of the Pulmonary Fissure, Extirpated by Uniportal VATS – Case Report and Review of Literature

Lipomas are common benign tumours characterised by soft moveable masses throughout various locations in the body. However, atypical localisation of the pulmonary fissure is uncommon. Herein is reported a rare case of a female with an asymptomatic lesion in the pulmonary fissure of the left lung, extracted by single-port video-assisted thoracoscopic surgery, with a good clinical and radiologic outcome. Single-port video-assisted thoracoscopic surgery technique with a brief review of relevant literature will be discussed.

Meta-analysis of subxiphoid approach versus lateral approach for thoracoscopic Thymectomy

BackgroundCompared with traditional open surgery for thymectomy, video-assisted thoracoscopic surgery (VATS) reduces hospital stay, decreases postoperative pain, and recovers faster. VATS has become increasingly popular in the past decade. VATS techniques to perform a thymectomy include subxiphoid video-assisted thoracoscopic surgery (SVATS) or lateral video-assisted thoracoscopic surgery (LVATS). In this study, our objective was to systematically review on VATS thymectomy and draw a meta-analysis on the outcomes between the two approaches.MethodsWe searched online databases and identified studies from database inception to 2019 that compared SVATS to LVATS thymectomy. Study endpoints included operative time, operative blood loss, length of hospital stay, postoperative pleural drainage, postoperative complications, conversion to open, oncologic outcomes.ResultsFour hundred seventy-one patients were included in this study, for which 200 and 271 patients underwent SVATS and LVATS thymectomy, respectively. Patients in the SVATS group had significantly less operative time, operative blood loss, length of hospital stay, and postoperative complications were identified. There was no statistical difference in postoperative pleural drainage, conversion to open and oncologic outcomes. No hospital deaths were recorded for either procedure.ConclusionsWhile randomized controlled studies are required to make definitive conclusions, this meta-analysis suggests that SVATS thymectomy is safe and can achieve good and safe operative and perioperative outcomes similar or better to LVATS thymectomy.

Uniportal video-assisted right S9–10 anatomical segmentectomy: how to do it

Video-assisted thoracoscopic surgery (VATS) lung-sparing anatomical resections preserve healthy pulmonary parenchyma but also lead to good resection margins. Oncological outcomes are similar when compared with lobectomy for the treatment of early stage lung adenocarcinoma. VATS technique to perform classical anatomical segmentectomies is well defined and even in highly experienced teams, these procedures can be performed by uniportal VATS. However, the achievement of unusual central anatomical segmentectomies through Uniportal VATS remains a challenge. We describe a feasible and reproducible technique to perform uniportal VATS right lower lateral and posterior (S9–10) anatomical segmentectomy for the treatment of early stage lung cancer.

Uniportal VATS technique for primary spontaneous pneumothorax: An analysis of 46 cases.

Objective:In the treatment of primary spontaneous pneumothorax (PSP), the influence of safety and applicability of uniportal video assisted thoracoscopic surgery (VATS) bullectomy/blebectomy and pleurectomy method were evaluated in 46 patients.Methods:Between November 2010 and January 2019, 46 patients (36 males, 10 females; mean age 24.2 years; range 16-36 years) undergoing uniportal video thoracoscopic bullectomy/blebectomy and apical pleurectomy for primary spontaneous pneumothorax were evaluated retrospectively at Canakkale Onsekiz Mart University (COMU). One patient underwent surgery for the second time after three months for contralateral pneumothorax and counted as two different patients, hence forty seven operations were performed in total. The cases were evaluated in terms of age, gender, comorbidity, duration of hospital stay, histopathological diagnosis, postoperative morbidity and mortality.Results:Right surgical intervention was performed in 20 cases (42.6%) and left surgical intervention in 27 cases (57.6%). A total of 15 (31.9%) surgical operations were performed during the first attack, 30 (63.8%) during the second attack and 2 (4.3%) during third and more attacks. There was prolonged air leakage in all patients operated during the first episode. All cases underwent wedge resection and pleurectomy with endoscopic stapes. None of the patients required thoracotomy. Postoperative drainage period was between 2-7 days (mean: 4.1) and the duration of hospitalization was between three to eight days. Postoperative pain and paraesthesia were observed in eight cases. Prolonged air leakage was observed in five cases.Conclusion:With video thoracoscopic uniportal technique, not only lung biopsy and resection but also bullectomy/blebectomy and pleurectomy operations can be performed safely in the treatment of PSP. In view of this information, minimally invasive techniques are seen as more advantageous than conventional techniques.

Robotic sleeve lobectomy for centrally located non–small cell lung cancer: A propensity score–weighted comparison with thoracoscopic and open surgery

ObjectiveTo evaluate the surgical and oncologic outcomes of robotic sleeve lobectomy in comparison with video-assisted thoracoscopic surgery (VATS) and open surgery. MethodsSurgical outcomes in patients with non–small cell lung cancer who underwent sleeve lobectomy via robotic, VATS, and thoracotomy were assessed using the χ2 test, Fisher exact test, and the Kruskal–Wallis rank sum test. Log-rank test and Cox proportional hazards model were used in survival analyses. Propensity score–weighted matching was used to achieve the balance of baseline among the 3 groups. ResultsBetween 2012 and 2017, 188 patients were included and divided into robotic (n = 49), VATS (n = 73), and open (n = 66) groups. After weighted matching that retained all patients, no statistical difference in 90-day mortality or morbidity among the 3 groups was shown. Patients in the robotic group had less bleeding loss (P < .001), operative time (P < .001), and tube drainage time (P < .001) than the other 2 groups. No positive bronchial margin or conversion presented in the robotic group. In multivariable analyses, surgical technique was independently associated with neither overall survival nor disease-free survival (P > .050). ConclusionsRobotic sleeve lobectomy is a safe, feasible, and effective procedure. Compared with VATS and open techniques, robotic sleeve lobectomy has a similar oncologic prognosis for patients with centrally located non–small cell lung cancer. Further studies with a larger sample size and long-term follow-up are needed.

Uniportal Video-assisted Thoracoscopic Surgery for Pulmonary Aspergilloma: A Report of 5 Cases.

Pulmonary aspergilloma is an uncommon pulmonary disease that complicated with many other respiratory disorders. Despite advances in medication, surgical treatment continues to form the basis of aspergilloma treatment. However, the use of uniportal video-assisted thoracoscopic surgery is extremely limited in pulmonary aspergilloma. In this report, 5 patients who underwent anatomic pulmonary resection safely with uniportal video-assisted thoracoscopic surgery technique without requiring a traditional thoracotomy were presented.

The Feasibility and Advantages of Subxiphoid Uniportal Video-Assisted Thoracoscopic Surgery in Pulmonary Lobectomy

BackgroundUniportal video-assisted thoracoscopic surgery (VATS) lobectomy has emerged as a promising and exciting approach for minimally invasive thoracic surgeries. However, nearly all reported uniportal VATS lobectomies are performed via an intercostal route, and chest wall trauma remains an issue. Here, we report the use of a novel uniportal VATS technique involving a subxiphoid route for pulmonary lobectomies.MethodsWe retrospectively analyzed perioperative data for patients who underwent subxiphoid uniportal and traditional three-port VATS lobectomies from January 2016 to January 2017 at our hospital.ResultsDuring the study period, 37 patients successively underwent subxiphoid uniportal VATS lobectomies, including three synchronous bilateral pulmonectomies; 68 patients underwent traditional three-port VATS. There were no surgical or 30-day postoperative mortalities, and no significant between-group differences were found in the number of retrieved lymph nodes, number of explored nodal stations, blood loss, drainage time, postoperative complications, or length of hospital stay. Operative time was longer in the subxiphoid uniportal VATS group than in the traditional three-port VATS group (P < 0.001). Visual analog scale (VAS) pain scores after surgery were significantly lower in the subxiphoid uniportal VATS group (P < 0.05).ConclusionsSubxiphoid uniportal VATS lobectomy is a safe and feasible surgical procedure associated with reduced surgical trauma and postoperative pain as well as improved cosmetic results compared with traditional VATS. Moreover, this procedure is better suited for patients receiving synchronous bilateral pulmonectomy. Further long-term follow-up analyses involving more patients are ongoing.Trial registry numberClinicalTrials.gov NCT03051438.

The effects of ultrasound-guided serratus plane block, in combination with general anesthesia, on intraoperative opioid consumption, emergence time, and hemodynamic stability during video-assisted thoracoscopic lobectomy: A randomized prospective study.

Background:Thoracotomy is one of the most painful surgeries; therefore, video-assisted thoracoscopic surgery (VATS) was developed to reduce the surgical stress of thoracotomy. Although VATS results in reduced postoperative pain compared with thoracotomy, it is still painful. Serratus plane block (SPB) is a novel technique that provides lateral chest wall analgesia by blocking the lateral branch of the intercostal nerve.Methods:We conducted a prospective study in 50 patients, aged 20 to 75 years, undergoing three-port VATS lobectomy. Group G (n = 25) received conventional general anesthesia and Group S (n = 25) received SPB before induction of general anesthesia. In Group S, 20 ml of 0.375% ropivacaine was injected between the serratus anterior and latissimus dorsi muscles. During surgery, anesthesia was maintained by adjusting the propofol dose to maintain a bispectral index of 40 to 60 and the remifentanil dose to maintain blood pressure and heart rate within 70 to 130% of baseline.Results:Intraoperative remifentanil consumption was significantly lower in Group S compared to that in Group G (519.9 μg vs 1047.7 μg, P < .001). Moreover, emergence time was significantly shorter in Group S compared to Group G (10.8 minutes vs 14.9 minutes, P = .01). However, there were no significant differences in systolic blood pressure and heart rate (HR) between the groups at each time point. The doses of rescue drugs for the control of blood pressure and HR were not significantly different between the 2 groups.Conclusions:Ultrasound-guided SPB could be a safe and effective regional anesthesia technique for VATS

National practice trends for the surgical management of lung cancer in the CMS population: an atlas of care.

Video-assisted thoracoscopic surgery (VATS) has been established as a safe and effective alternative to an open approach for the treatment of early-stage lung cancer. Despite this, differences in utilization across the nation are present. The aims of this study were to: (I) characterize trends in the use of open surgery and VATS for the management of lung cancer across the United States, and (II) describe if particular regions of the country utilize minimally invasive surgery more frequently. We studied all Medicare beneficiaries from the ages of 65 to 99 years with full Part A and B coverage and no HMO coverage for the years of 2006 and 2014 (the most recent year available at the time of this analysis). Beneficiaries with a diagnosis of lung cancer (ICD-9 codes: 162.0 162.2 162.3 162.4 162.5 162.8 162.9) were selected. Rates of thoracoscopic surgery (CPT codes: 32663, 32666, 32667, 32668, 32669, 32670, 32671) and open lung resections (32505, 32506, 32507, 32608, 32440, 32442, 32445, 32480, 32482, 32484, 32486, 32488) were calculated by year and region. Rates in 2006 and 2014 with descriptive statistics and a univariate analysis were performed using Student's t-test and chi-square, as appropriate. A two-sided P value <0.05 was considered statistically significant. A total of 24,368,333 and 23,921,059 beneficiaries for the years of 2006 and 2014 were analyzed. A diagnosis of lung cancer was detected in claims of 167,418 patients (0.7%) in 2006 and 167,506 patients in 2014 (0.7%), which was not significantly different (P=0.7). Among these lung cancer patients, a surgical intervention was performed in 17,249 patients (10.3%) during 2006 and 18,603 patients (11.1%) in 2014 (P=0.01). Among those undergoing surgery, a VATS approach was performed in 2,512 patients (15%) during 2006 and 9,578 patients (54%) during 2014 (P=0.001). In 2006, California, New York, and New Jersey performed the most VATS procedures, in comparison to 2014, when New York, Florida, and California performed the highest number of VATS procedures. While the prevalence of lung cancer in the United States was unchanged between 2006 and 2014, the use of VATS techniques increased five-fold. Further studies to better understand the adoption or availability of new surgical techniques in lung cancer populations across geographic regions and patient populations are necessary.