Subxiphoid, Nonintubated, Opioid-Free, Video-Assisted Pneumonectomy: A New Frontier in Thoracic Surgery

Area of Science:

• Thoracic surgery
• Anesthesiology
• Minimally invasive procedures

Background:

• Surgical techniques for pulmonary resections have advanced from thoracotomy to video-assisted thoracoscopic surgery (VATS), including uniportal VATS.
• Recent innovations include subxiphoid extrathoracic access and nonintubated, opioid-free anesthesia, showing promise in safety and recovery.
• Limited literature exists on hybrid approaches combining these advanced techniques for pneumonectomy.

Observation:

• This report presents a case of pneumonectomy utilizing a hybrid approach.
• The technique incorporated both subxiphoid extrathoracic access and nonintubated, opioid-free anesthesia.
• The authors detail the preoperative workup, surgical and anesthesia considerations, and postoperative recovery.

Findings:

• The hybrid approach combining subxiphoid access and nonintubated, opioid-free anesthesia was technically feasible for pneumonectomy.
• The procedure was performed safely, with no immediate complications reported.
• The patient experienced a favorable postoperative recovery.

Implications:

• This hybrid technique may offer a safe and effective alternative for pneumonectomy.
• It holds the potential for enhanced recovery and improved patient outcomes.
• Further research is warranted to validate these findings in a larger patient cohort.