Stapler-Less Uniportal Video-Assisted Thoracoscopic Surgery: A Case Series and Review of the Literature

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach widely used for lung resections. However, reliance on staplers increases costs, limiting its adoption in resource-constrained settings. This study evaluates the feasibility, safety, and cost-effectiveness of uniportal stapler-less VATS lobectomies and segmentectomies.

A retrospective analysis of 7 stapler-less uniportal VATS surgeries performed between March 2021 and February 2022 was conducted. Data on operative time, blood loss, postoperative outcomes, and complications were collected from patient records.

Seven procedures were completed with an average operative time of 80 min (range: 48-118 min). Estimated blood loss was minimal (10-100 mL) in 6 cases. One patient required conversion to open thoracotomy due to vessel injury. Postoperatively, all patients were stable with no major complications.

Stapler-less VATS is a viable, cost-effective alternative to conventional techniques, offering comparable safety and outcomes. This approach supports broader adoption of minimally invasive surgery, particularly in low-income settings, where reducing procedural costs is critical.