Non-intubated uniportal left-lower lobe upper segmentectomy (S6)

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Pulmonary Medicine

Background:

• Anatomical segmentectomies are indicated for early-stage lung cancers, metastases, and benign conditions.
• Uniportal video-assisted thoracic surgery (VATS) offers a less invasive approach for these resections.
• Non-intubated spontaneously breathing management for VATS is gaining traction but lacks standardized criteria.

Observation:

• A 62-year-old male patient with two pulmonary metastases from adenocarcinoma underwent a single-incision, non-intubated uniportal VATS left-lower lobe (LLL) upper segmentectomy (S6).
• The procedure was performed under spontaneous breathing with intercostal blockade.
• The total operation time was 240 minutes, with chest tube removal at 24 hours and discharge on postoperative day 2.

Findings:

• Non-intubated uniportal VATS was successfully performed for a lung-sparing anatomical segmentectomy.
• The patient experienced no postoperative complications.
• The procedure demonstrated feasibility in a selected patient with metastatic lung disease.

Implications:

• Non-intubated uniportal VATS is a safe and viable option for selected patients requiring lung-sparing resections.
• Further research is needed to establish clear selection criteria and advantages over standard intubated VATS.
• This approach may enhance patient recovery and reduce invasiveness in thoracic surgery.