Thoracoscopic/Hybrid Right Upper Lobectomy, Chest Wall Resection

The safety of thoracoscopic lobectomy has been demonstrated and minimally invasive techniques are seeing increasing use in general thoracic surgery. With minimally invasive techniques, postoperative outcomes can involve decreased pain, blood loss, shorter length of stay, and improved compliance with adjuvant therapy.

More recently, thoracoscopic techniques have been used to supplement conventional open approaches and a number of centers are applying a hybrid approach to locally advanced lung cancer.

The resection of locally advanced lung cancer is generally accomplished with thoracotomy. When possible, the authors use a hybrid approach. While patients must be carefully selected, the initial experience is promising. The initial exploration with a thoracoscope offers the benefit of avoiding a non-therapeutic thoracotomy in unresectable disease.

This video illustrates two cases of invasive right upper lobe tumors. VATS exploration through a standard anterior, two-incision, approach directs a secondary counter incision.