Uniportal video-assisted thoracoscopic segmentectomy

Abstract

Uniportal video-assisted thoracoscopic surgery (VATS) segmentectomy is a technically more complex procedure than uniportal VATS lobectomy, since a detailed comprehension of the segmental anatomy is required. Anatomic sublobar resection can achieve outcomes equivalent to lobectomy in selected patients with stage IA non-small cell lung carcinoma (NSCLC). In this paper we describe our clinical experiences and introduce the technical details of uniportal VATS segmentectomy, including expertise advice ("tips and tricks") in patient selection, positioning and incisions and technical highlights of the most common types of segmentectomies. Uniportal VATS segmentectomy is a demanding technique, safe and feasible in selected patients with good results in the literature that seems to be an acceptable alternative to conventional VATS or open thoracotomy when the surgeon completed the training period and learning curve.

Uniportal video‐assisted thoracoscopic left S4 anatomical segmentectomy

“…VATS segmentectomy is particularly valuable for the lung‐sparing resection of deeply located small nodules, as in this case, and thus it was employed as treatment for this patient . In general, lingular (S4 + S5) segmentectomy is used for SPLs in the lingular segment . Yamashita et al .…”

“…Although technically complex, it presents an acceptable alternative to conventional VATS. Segmentectomy via a uniportal VATS approach requires a complete understanding of anatomic structures . In our case, uniportal left S4 segmentectomy was performed to treat a GGO located deep in S4.…”

“…9 In general, lingular (S4 + S5) segmentectomy is used for SPLs in the lingular segment. 7 Yamashita et al reported the use of S3 + S4 segmentectomy and S3b + S4 segmentectomy for the treatment of tumors located between the upper division and lingular segment. 10 Left S4 anatomical segmentectomy was employed in this case, aiming to ensure complete excision of the lesion while preserving pulmonary function.…”

“…Studies of VATS segmentectomy have mainly focused on posterior, superior, dorsal, basal, and lingular segmentectomy . Lingulectomy is performed with left S4 + S5 segmentectomy.…”

“…1,5 Studies of VATS segmentectomy have mainly focused on posterior, superior, dorsal, basal, and lingular segmentectomy. [6][7][8] Lingulectomy is performed with left S4 + S5 segmentectomy. To the best of our knowledge, left S4 segmentectomy alone has never been reported.…”