(Section 1) Video-Assisted Thoracoscopic Surgery has evolved significantly
over the last twenty years and is increasingly becoming the preferred method for lung
resection. It has and continues to be refined and improved with an increasing body of
evidence to support it over open surgery.
(Section 2) In this chapter, the author defines and briefly describes Mini-Uniportal
VATS (Uni-VATS).
The introduction of Video-assisted thoracic surgery (VATS) via a short (Mini) Single
skin incision and a port (trocar) provides an alternative to already established access to
the thoracic cavity and a novel surgical approach to pulmonary operations.
There has been a debate about the definition of “Uni- VATS” and how short in extent
characterizes the adjective “mini”? Many surgeons define “uniportal” as a VATS
operation performed through an incision of 4-8 cm, others believe that when the skin
exceeds 2 cm the name should be mini-thoracotomy. We define Uni-VATS an
operation in which the operation in the chest is performed when a port (trocar) is
introduced via a minimal skin incision of 2-3 cm, whereas when a larger incision is
made, the operation should be called single–incision-video assisted-mini thoracotomy.
Uni- VATS for lung cancer has been successfully used to perform a range of
pulmonary operations from wedge excision to pneumonectomy and more sophisticated
procedures. Double lumen tube and controlled ventilation is the preferred method to
carry out Uni-VATS, but more recently, the feasibility of non-intubated normal
breathing method has also been explored in selected patients undergoing major lung
resection. Although the first uniportal lobectomy was performed almost 10 years ago,
there have only been a few retrospective comparative studies and only one prospective
randomized trial between single-port and multi-port lobectomy.
With the advance in technology and imaging devices matched by experience and
surgical expertise, one may speculate that within a decade uniportal computer-assisted,
instrument-controlled surgery will open up a new horizon, allowing Uni- VATS to
become a routine practice for surgical treatment of lung cancer.
Keywords: Lung cancer, Minimally invasive thoracic surgery, Minimal incision,
NSCLC, Single port, Single trocar, Uniportal, VATS, Video-Assisted
Thoracoscopic Surgery.
