A new thoracoscopic technique for pulmonary lobectomies

Video-assisted thoracoscopic surgery (VATS) for pulmonary lobectomies has recently been introduced as a minimally invasive technique for selected patients. Herein I describe an original technique, which allows for lobectomies under the direct vision of a surgeon respecting the principles that are the basis of the thoracoscopic techniques. The originality of the technique consists in the supine position of the patient and the use of a modified retractor for lower lobectomies. This approach required two ports, an access incision (6-7 cm), and an additional port which may be used for lower lobectomies. Utilizing this technique I operated on twenty patients affected by stage I lung cancer with poor respiratory function. The ability to perform lobectomies with this method allows for shorter operative time than when utilizing previous techniques (80 min. mean operative time) including the lymph nodal dissection. Moreover, cosmetic results were good and patients benefited from excellent early pulmonary function and fast recovery time. I recommend the use of this approach which is a safe technique for the patient and an advantageous procedure for both surgeon and anaesthesiologist.