Subxiphoid single-port video-assisted thoracoscopic surgery

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• The subxiphoid single-port approach offers a minimally invasive alternative for chest surgery.
• Preliminary experience with this technique is evaluated for feasibility and safety.

Purpose of the Study:

• To assess the feasibility and safety of subxiphoid single-port thoracoscopic surgery.
• To analyze patient characteristics and outcomes for this novel surgical approach.

Main Methods:

• 39 patients underwent 40 thoracoscopic surgeries using a 3-4 cm subxiphoid incision.
• A sternal lifter and zero-degree deflectable scope were utilized.
• Anatomic resection techniques mirrored traditional single-port methods.

Main Results:

• The study included 39 patients (29 female, 10 male) with a median age of 56.
• Indications included lung cancer, metastases, benign lesions, pneumothorax, and mediastinal tumors.
• No surgical mortality occurred; 10% complication rate included bleeding, chylothorax, and arrhythmia.

Conclusions:

• Subxiphoid single-incision thoracoscopic pulmonary resection is safe with careful patient selection and instrument adaptation.
• Prior single-port experience is crucial for surgeons.
• Limitations include instrument crowding, cardiac interference, and challenges with complex cases.