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Related Experiment Video

Updated: Aug 7, 2025

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
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Uniportal vs. multiportal thoracoscopic segmentectomy: a north American study.

Ilitch Diaz-Gutierrez1, Charles Antoine Menier2, Félix H Savoie-White2

  • 1Department of Surgery, Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, MN, USA.

Journal of Thoracic Disease
|March 13, 2023
PubMed
Summary

Uniportal video-assisted thoracoscopic surgery (VATS) segmentectomy shows comparable outcomes to multiportal VATS in North American centers. Experienced surgeons achieve similar results in operating time, complications, and hospital stay for both VATS approaches.

Keywords:
Uniportalmultiportalsegmentectomythoracoscopicvideo-assisted thoracoscopic surgery (VATS)

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Uniportal video-assisted thoracoscopic surgery (VATS) segmentectomy is increasingly adopted globally.
  • North American experience with uniportal VATS segmentectomy remains limited.
  • This study compares uniportal versus multiportal VATS segmentectomy in a North American multicenter setting.

Purpose of the Study:

  • To compare the outcomes of uniportal VATS segmentectomy with multiportal VATS segmentectomy.
  • To evaluate the feasibility and safety of uniportal VATS segmentectomy in North America.
  • To assess perioperative data and postoperative complications between the two VATS approaches.

Main Methods:

  • Retrospective chart review of prospectively collected data from two North American centers (2012-2020).
  • Inclusion of all VATS segmentectomy patients, excluding emergent cases and combined resections.
  • Propensity score matching (1:1) to compare outcomes between uniportal and multiportal VATS cohorts.

Main Results:

  • A total of 423 VATS segmentectomies were performed (181 uniportal, 242 multiportal).
  • Operating time was significantly lower for uniportal VATS (130 min) compared to multiportal VATS (161 min) (P<0.001).
  • No significant differences were observed in estimated blood loss, severe complications, conversion rates, resection margins, nodal upstaging, hospital stay, or 30-day mortality.

Conclusions:

  • Uniportal VATS segmentectomy demonstrates comparable postoperative outcomes to multiportal VATS segmentectomy.
  • In experienced hands, uniportal VATS is a safe and effective alternative for lung segmentectomy in North America.
  • The findings support the wider adoption of uniportal VATS segmentectomy in the region.