Uniportal Video-Assisted Thoracoscopic Left Upper Lobectomy with “Reverse Direction” Technique

Abstract

AbstractThe uniportal access video-assisted thoracic surgery has now become an increasingly popular approach to manage thoracic surgical diseases. Among all lobes, left upper lobectomy is considered a difficult procedure via a single incision. Although there are many reports on this technique, standard procedure has not come to an agreement yet. A 50-year-old woman was admitted to our hospital for finding of a left upper lobe lesion for 2 months. No abnormal signs were observed in physical and laboratorial tests. A ground-glass opacity nodule was detected on the left upper lobe on computed tomography. No enlarged lymph nodes or distant metastasis was detected. Early-stage lung cancer was initially diagnosed in this patient. Contrast with traditional uniportal left upper lobectomy procedures, our procedure has a reversed order of dissection. The arterial branches were divided first; then, the upper bronchus, the apicoposterior artery, and upper vein was stapled together at last. On our observation and experience, this procedure can simplify the uniportal left upper lobectomy procedure and reduce operation time potentially. Additionally, we would like to introduce our improved closure technique for uniportal video-assisted thoracic surgery: double-embedding stitching method.