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Related Experiment Video

Updated: Jan 20, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Multiportal subxiphoid thoracoscopic major pulmonary resections.

Karel Pfeuty1, Bernard Lenot1

  • 1Department of Thoracic and Vascular Surgery, Hôpital Yves Le Foll, Saint-Brieuc, France.

Journal of Thoracic Disease
|August 30, 2019
PubMed
Summary

Subxiphoid video-assisted thoracoscopic surgery (SVATS) offers a less invasive option for major pulmonary resections. This approach leads to shorter hospital stays and improved recovery compared to conventional VATS.

Keywords:
Enhanced Recovery After Surgery (ERAS)Video-assisted thoracoscopic surgery (VATS)multiportalsubxiphoid

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Pulmonary Medicine

Background:

  • Emerging subxiphoid video-assisted thoracoscopic surgery (SVATS) approaches aim to reduce invasiveness and morbidity in major pulmonary resections.
  • The core principle involves minimizing intercostal nerve trauma without compromising safety or oncologic outcomes.

Purpose of the Study:

  • To describe and evaluate the initial experience with multiportal SVATS for major pulmonary resections.
  • To compare the outcomes of multiportal SVATS with conventional video-assisted thoracoscopic surgery (CVATS).

Main Methods:

  • Retrospective comparison of 75 patients undergoing multiportal SVATS with 75 patients undergoing historic CVATS for major pulmonary resections.
  • SVATS approach utilized single or double access under the costal arch, with optional 5-mm intercostal ports.

Main Results:

  • SVATS achieved 51 lobectomies, 20 segmentectomies, and 4 pneumonectomies, with 68 malignant and 7 benign lesions.
  • No significant differences in conversion rates, operative time, morbidity, or 30-day mortality between SVATS and CVATS groups.
  • SVATS group demonstrated significantly shorter drainage duration (1 vs. 3 days) and hospital stay (2 vs. 4 days), with comparable postoperative pain relief and reduced persistent opioid use.

Conclusions:

  • Multiportal SVATS is a safe, oncologically sound, and reproducible method for major pulmonary resections.
  • This approach facilitates opioid-free analgesia, leading to shorter hospitalizations and enhanced recovery compared to CVATS.