[Video-thoracoscopic pulmonary lobectomy. Our experience]

Video-endoscopic surgery developed from laparoscopic removal of the gallbladder and can be used for treatment of certain disease processes of the chest. The major application of this technique is the performance of pulmonary resections (lobectomies and pneumonectomies). Video-thoracoscopic lobectomy requires general anesthesia with a double lumen intubation. After collapse of the involved lung, two intercostal incisions are performed (the first one in seventh space, mid axillary and the second one in fifth space, below the angle of the scapula) and an additional mini-thoracotomy (submammillary in the fifth space) is made. The lobar arteries, veins and bronchus are occluded with an automatic endoscopic stapling device. Seven cases of pulmonary neoplasms (stage I) have been treated by video pulmonary lobectomy (3 right lower lobectomies, 2 right upper lobectomies, 2 left lower lobectomies). Two procedures have been converted for an advanced neoplastic stage that required a radical pneumonectomy and an uncontrolled bleeding. This new procedure has the advantage of greatly reducing the pain and ventilatory disability associated with conventional open thoracic surgery.