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Related Experiment Video

Updated: May 29, 2026

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
04:38

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

Published on: April 19, 2024

Closed chest lobectomy with subxyphoid retraction.

Alaaddin Yilmaz1, Bart Pieter Van Putte, Wim-Jan Van Boven

  • 1Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.

Interactive Cardiovascular and Thoracic Surgery
|September 20, 2011
PubMed
Summary

A novel video-assisted thoracoscopic surgery (VATS) lobectomy technique in the supine position avoids rib traction during specimen removal. This approach facilitates complete lymph node dissection and subxyphoidal lobe extraction, enhancing patient comfort.

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Procedures
  • Surgical Techniques

Background:

  • Video-assisted thoracoscopic surgery (VATS) lobectomy is a standard minimally invasive approach for lung cancer resection.
  • A key limitation of VATS lobectomy is the minithoracotomy incision required for specimen extraction, which can cause rib cage traction and discomfort.
  • Current VATS techniques may still involve some degree of rib retraction, potentially leading to post-operative pain.

Purpose of the Study:

  • To introduce and describe a novel VATS lobectomy technique performed in the supine position.
  • To demonstrate a method for specimen removal that eliminates rib traction during VATS lobectomy.
  • To highlight the benefits of subxyphoidal specimen extraction in VATS procedures.

Main Methods:

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Last Updated: May 29, 2026

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  • The study describes a modified VATS lobectomy performed with the patient in the supine position.
  • The technique involves complete lymph node dissection.
  • Specimen extraction is achieved through a subxyphoidal incision, avoiding the need for rib retractors or significant rib spreading.

    • Main Results:

    • The described technique successfully removes the resected lobe(s) without causing any degree of traction on the ribs.
    • Complete lymph node dissection is feasible with this approach.
    • The subxyphoidal removal method minimizes surgical trauma to the thoracic cage.

    Conclusions:

    • This supine VATS lobectomy technique offers a significant advantage by eliminating rib traction during specimen removal.
    • The described method provides a viable alternative for VATS lobectomy, potentially improving patient outcomes and reducing post-operative morbidity.
    • Further studies are warranted to evaluate the long-term efficacy and patient-reported outcomes of this innovative surgical approach.