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A 3.5 cm Single Incision VATS Lobectomy for Lung Cancer

Tuesday, June 17, 2014

In this video, a single 3.5 cm incision was used for a VATS right upper lobectomy and lymph node dissection for non-small cell carcinoma in a 61-year-old female patient. The incision was only slightly larger than a chest tube insertion incision.

This video is available in the CTSNet China Resource Center for CTSNet users who are unable to view videos due to YouTube restrictions.


Nice job and tiny incision. Your incision is quite a bit lower than Diego Gonzalez rivas' teaches. Have you tried his level and gone lower or do you always go this low. Diego tells us to go for the truncal branch first also rather than the vein but that is due to the angles that his incision gives. I use a 5mm camera now so there is less bulk of the camera in the wound. Have you tried this ? Great job. Keep up the good work.
Thank you for comments and questions. We have been using the single incision VATS (SIVATS) since 2010 mainly for thoracal sympathectomy, parietal pleurectomy for MPE, pulmonary wedge resection, recurrent pneumothorax and mediastinal tumor excision of all three compartments. The number of SIVATS procedures at our department exceeded 300 in last 4 years. For lung cancer patients, our approach was two or three ports standard VATS lobectomy and LND. We started to perform SIVATS Lobectomy in 2013 by using 5cm incision and lowered it even to 2 or 3cm in time. Resection was almost always possible through this small incision but removal of the lobe was not, as expected. The smallest lenght we have achieved so far is 3cm that was in a 4 year old boy who underwent SIVATS lobectomy for CCAM. In contrast to Dr Rivas's recommendation of "the artery first" for upper lobectomy for easier resection, we have found no difficulties at all with the classical oncological teaching's of "the vein almost first" approach in any case. Because the 5mm camera gets blurry very easily during the operation I prefer 10mm camera whenever possible.

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