Subxiphoid single-port pulmonary bilateral metastasectomy

Pulmonary wedge resection for bilateral metastatic pulmonary tumor is generally performed via a bilateral lateral intercostal approach by one-stage or two-stage surgery. In 2014, we reported subxiphoid single-port pulmonary bilateral metastasectomy to resect bilateral pulmonary metastases via a single subxiphoid wound. This approach of bilateral pulmonary wedge resection via a 3-cm single wound in the epigastric fossa enables one-stage bilateral pulmonary resection with the patient in the supine position, without changing position, and because the intercostal space is not involved, there is no intercostal nerve injury. This procedure is a useful and enables minimally invasive surgery for patients who require surgery of the bilateral lungs, such as bilateral metastatic pulmonary tumors and bilateral spontaneous pneumothorax. However, one of the drawbacks of this approach is limited maneuverability. Future developments in instruments and surgical techniques including new single-port robot systems will help improve the limited maneuverability, given its benefits to the patient, as a surgical approach in thoracic surgeries.