Video-Assisted Thoracic Surgical Non-Rib Spreading Simultaneously Stapled Lobectomy

Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting

“…Although open thoracotomy has long been considered the standard approach to lung cancer surgery, many reports have described the effectiveness of VATS for early-stage lung cancer (1)(2)(3)(4). Two monitor settings are available for VATS lobectomy.…”

“…Lobectomy with systemic lymph node dissection (SND) is the standard treatment for patients with stage I or II non-small cell lung cancer. VATS lobectomy for treatment of primary lung cancer has become increasingly accepted as a minimally invasive surgery and is now widely performed (1)(2)(3)(4). However, the monitor setting and port placement differ among hospitals.…”

Is “en masse” lobectomy feasible in the recent era?

“…''En masse'' lobectomy may be contradictory to this strategy for cure of cancer. In the previous report, bronchial stumps could be kept on averaged 4 mm distance and comparable to the distance by anatomical hilar dissection [6]. In addition, none of 214 patients operated ''en masse'' lobectomy did not show any locoregional recurrences even if the hilar nodes were involved.…”

The Evolution of VATS Lobectomy

“…This bold but simple technique permitted efficient resection of a lung lobe in the early days of VATS when the intricate skills needed for conventional isolation-ligation of individual hilar structures via the small incision were still being developed. Even in the early 1990s, in his first 200 consecutive patients using this technique, Lewis claimed impressively short average operating times of 79.5 minutes and length of hospital stay of 3.07 days (Lewis & Caccavale, 2000). There was no mortality and minor complications were only noted in 13% of patients.…”