Needlescopic-assisted uniportal video-assisted thoracoscopic pulmonary anatomical segmentectomy

Abstract

Background: Pulmonary segmentectomy can be an oncologic equivalent of lobectomy for small nonsmall cell lung cancer. Uniportal video-assisted thoracoscopic surgery (VATS) has recently showed favorable surgical outcomes, but remains technical demanding, especially in a complex procedure like anatomic segmentectomy. This manuscript demonstrates the surgical techniques for uniportal VATS segmentectomies with the assistance of additional needlescopic instruments. Results: There were 12 uni-segmentectomies, 10 bi-segmentectomies, and 2 tri-segmentectomies. The mean operation time was 178.3 minutes. The mean duration of chest tube drainage was 5.2 days, and the mean duration of hospital stay was 7.4 days. There were two episodes of major bleeding and one case that required conversion to lobectomy.Conclusions: Under the assistance of additional needlescopic instruments, segmentectomy can be performed more easily and safely with uniportal VATS.

Segmental Resection in Early-Stage Lung Cancer

“…In lesions that are difficult to localize and deep within the parenchyma, preoperative localization techniques are helpful. • Three-dimensional reconstruction and spatial orientation [4] • CT guided wire placement/needloscopic [5,6] • Intraoperative imaging-radiograph/ultrasound…”