Setting: University referral center. Patients: Six consecutive patients with a pneumothorax who underwent video-assisted thoracic surgery through a single skin incision. Interventions: A flexible digital bronchoscope was placed in a scope guide. A single 2.0-cm skin incision was made in the midaxillary line. The entire lung was carefully explored. An endoscopic stapling device was then inserted, and the lung resection was performed through a single skin incision. Primary Outcome Measures: Operative time, estimated amount of blood loss, operative complications, and postoperative air leakage were recorded. Results: The video-assisted thoracic surgery procedure throughasingleincisionwassuccessfulinall6patients.There were no associated complications at 1-year follow-up. Conclusions: We were able to perform the videoassisted thoracic surgery procedure through a single skin incision using a scope guide and a flexible scope that enables visualization of the entire pleural cavity, providing even laser ablation. This new technique can be used to treat patients with pneumothoraces without the need for additional skin incisions.

ObjectivesOur aim of this study was to quantify the physical demands of elite rugby union players by each position as a step towards designing position-specific training programme using a Global Positioning System/accelerometer system.MethodsThis study was performed as a retrospective observational study. Data were obtained from 45 official matches. The sample size used for the analysis was 298. The per-match total distances, accelerations and impacts were calculated and statistically compared for the forwards and backs and for individual positions.ResultsTotal distances for the forwards and backs were 5731.1±507.8 and 6392.1±646.8 m, respectively. The high-velocity running distances (>18.0 km/hour) covered by the forwards and backs were 317.4±136.9 and 715.0±242.9 m, respectively. The number of accelerations (>1.5 m/s2) for the forwards and backs were 76.3±18.9 and 100.8±19.6 times, respectively, and the number of high impacts (>10 g) were 48.0±46.9 and 35.6±28.3 times for the forwards and backs, respectively. All characteristics were significantly different between the forwards and backs (p<0.05). The per-position characteristics were also calculated. Within the backs, scrum half (SH) and wingers (WTBs) covered high-velocity running significantly higher distance than fly-half (SH d=2.571, WTBs d=1.556) and centres (SH d=1.299, WTBs d=0.685) (p<0.05).ConclusionBy clarifying the physical demands according to the positions, it will be possible to create optimised position-specific training programmes.

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The technique allowed healing without a scar and improved the patient's cosmesis.