Robot-Assisted Thoracoscopic Right Upper Lobectomy Under Two-Lung Ventilation With an Artificial Pneumothorax in a...

In thoracoscopic surgery, adequate collapse of the operative lung is usually necessary for surgical exposure, although one-lung ventilation (OLV) can be challenging in patients with underlying pulmonary disease or airway anomalies. We herein report a case in which robot-assisted thoracoscopic surgery (RATS) was safely performed using two-lung ventilation (TLV) with an artificial pneumothorax because OLV was difficult due to airway anomalies. A 46-year-old woman with a right tracheal bronchus and a narrow airway was scheduled to undergo a robot-assisted thoracoscopic right upper lobectomy. Due to the airway anomalies, establishment of OLV was difficult. Therefore, we performed the surgery under TLV with a single-lumen tracheal tube and an artificial pneumothorax. There were no complications during the surgery. The postoperative course was uneventful. RATS under TLV with artificial pneumothorax may be a viable alternative when OLV is not feasible.