Since there’s been quite a bit of interest in single-port thoracoscopic surgery (SITS) here at Cirugia de Torax.org – I’ve added information about SITS lobectomy. British surgeons, Rocco et. al had previously reported the outcomes of several wedge resections by uni-port (SITS) back in 2004 but this is the first case report that I’ve seen for lobectomies via this technique*.
Gonzalez et al. in Coruna, Spain published a case report of a lobectomy by SITS. The authors note that they have performed three cases by this technique at the time of article submission (November 2010).
As expected, the authors reported decreased post-operative pain and parathesias when using this technique. They also reported that while visibility is more limited with this approach, they feel that it is less problematic for surgeons already accustomed to, and familiar with double port lobectomies. This approach, in their experience, is best used for lower lobe lesions due to difficulties accessing and maneuvering for bronchial resection for upper lobectomies.
* If you’ve seen other published reports – please send the citations to the site.
Update: 25 July 2011
I contacted Dr. Gonzalez to inquire about his surgical experiences since the publication of the article this past March. Dr. Gonzalez reports that he and his colleagues (Dr. Mercedes De la Torre and Dr. Fernandez) have continued to practice SITS for lobectomies and other thoracic procedures, and that he is now using it for the majority of his cases.
Dr. Gonzalez states that many of his patients are discharged earlier (POD 2 or 3) and are experiencing less post-operative pain. He is planning future studies to demonstrate this.
I expect we’ll be hearing more about Dr. Gonzalez and his partners in the future.
Note: Dr. Chu in Beijing, China has also published cases in the literature with single port lobectomies.
Gonzalez D., Paradela M., Garcia J. & De la Torre M. (2011). Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg. 2011 Mar;12(3):514-5. Epub 2010 Dec 5. (free full-text article with photographs).
Rocco, G., Martin-Ucar, A. & Passera, E. (2004). Uniportal VATS wedge pulmonary resections. Ann Thorac Surg 2004;77:726-728. (free full text aricle with color photographs).