Intra-pericardial double sleeve uniportal video-assisted thoracoscopic surgery left upper lobectomy

The importance of parenchymal tissue preservation during lung resections is well realized in thoracic surgery. Technical refinement and anatomic insight have expanded indications for parenchymal -sparing surgeries. In thoracic surgery, it's reasonable to avoid pneumonectomy whenever it's possible, although challenging and technically more demanding than standard anatomic pulmonary resection, bronchial and/or vascular resection of a circumferential portion (sleeve resections) is a justified procedure due to its benefits of avoiding the complications of pneumonectomy in addition to preservation of pulmonary tissue and functions. In The era of video assisted thoracoscopic surgery's revolution and with the improvement of the surgical instruments and surgeon's experience, reports on multiportal and uniportal sleeve and double sleeve resections published recently in the literature. Here we present a video documented case of the Intra-pericardial double sleeve left upper lobectomy that demonstrates our technique in performing this surgery via uniportal approach.