Original Article on Thoracic Surgery
Uniportal video-assisted thoracoscopic lobectomy: Zhongshan experience
Abstract
Background: Uniportal video-assisted thoracoscopic surgery (VATS) is an emerging technique in the field of thoracic surgery. In this article, we aimed to describe uniportal VATS lobectomy that was conventionally performed in an Eastern center, which might help facilitate a good beginning in practice this technique.
Methods: The indications of uniportal VATS lobectomy are merely equal, if not the same, to multiportal VATS lobectomy. All patients would receive a combination of epidural and general anesthesia, and were provided with patient-controlled analgesia (PCA) postoperatively. Generally, the patient was kept in a folding knife gesture (with the cranial side slightly raised up and caudal side pushed down) in lateral decubitus position.
Results: In uniportal VATS lobectomy, the geographical view differed from multiportal VATS, while the thoracic cavity required carefully exploration to identify any unexpected invasion or metastasis. Since the incision was located at the anterior axillary line close to the anterior part of the hilar, the posterior part of the hilar, and diaphragm were far from the surgical incision.
Conclusions: Uniportal VATS, is not the happy ending in thoracic surgery. Beside its rapid progression, there remained a lot of questions to answer. Its uncovered benefits and drawbacks over traditional VATS, its possible improvements, and less invasive peri-operative managements could be the future topics. A comparison between uniportal versus multiportal VATS using high-level methodology is therefore required. With the development of surgical minds and instruments, uniportal VATS would have done more to the patients.
Methods: The indications of uniportal VATS lobectomy are merely equal, if not the same, to multiportal VATS lobectomy. All patients would receive a combination of epidural and general anesthesia, and were provided with patient-controlled analgesia (PCA) postoperatively. Generally, the patient was kept in a folding knife gesture (with the cranial side slightly raised up and caudal side pushed down) in lateral decubitus position.
Results: In uniportal VATS lobectomy, the geographical view differed from multiportal VATS, while the thoracic cavity required carefully exploration to identify any unexpected invasion or metastasis. Since the incision was located at the anterior axillary line close to the anterior part of the hilar, the posterior part of the hilar, and diaphragm were far from the surgical incision.
Conclusions: Uniportal VATS, is not the happy ending in thoracic surgery. Beside its rapid progression, there remained a lot of questions to answer. Its uncovered benefits and drawbacks over traditional VATS, its possible improvements, and less invasive peri-operative managements could be the future topics. A comparison between uniportal versus multiportal VATS using high-level methodology is therefore required. With the development of surgical minds and instruments, uniportal VATS would have done more to the patients.
