Posterior fissure first approach in single port video-assisted thoracoscopic surgery

More than 20 years have passed since thoracoscopic surgery became common as a low-invasive surgery. Thoracic surgeons have since aimed for further low-invasive surgical treatments and progress in this concept has resulted in an increase in reduced port surgery and new procedures such as robot-assisted surgery. Single-port video-assisted thoracic surgery (SPVATS) has already become common in some countries. It is an ultimate form of reduced port surgery and can be applied for the surgical treatment of most surgically-treated diseases including lung cancer. Regarding the approach to the interlobular regions in surgical procedures, it has been discussed which of the anterior fissure first and posterior fissure first is appropriate for multi-port VATS (M-VATS). In this report, the propriety of the posterior fissure first approach to the interlobular region in SPVATS lobectomy for early lung cancer is reviewed.