Uniportal Video-Assisted Thoracic Surgery, Feasibility and Ability

Introduction: A single incision video-assisted thoracic surgery (VATS) has revolutionized the way to treat lung patients. However, this approach represents a big challenge for thoracic surgeons and did not resonate well regionally.

Methods: All patients undergoing a single-incision VATS in the thoracic surgery division in our university hospital of Jena in Germany, between 01.01.2015 and 30.08.2017 were included. The patients were retrospectively analyzed using a prospective database with regard to baseline characteristics, surgical procedures, duration of surgery and chest tube, complications and length of stay in hospital.

Results: A total of 208 patients were conducted in this study, 84 females (40.4%) and 124 males (59.6%), with a mean age of 62.1 ± 15.6 years. Among these cases following was diagnosed: 43% lung cancer, 10% pleural effusion, 7% pneumothorax, 7% pulmonary metastases, 7% pleural empyema, 6% suspected mediastinal lymph nodes and 20% other benign thoracic lesions. The mean operating time was 67.31 ± 41.8 minutes. There was no significant difference in operating time with regard to lobe specific localization. The chest tube could be removed at the first postoperative day in 180 patients (87%). Only 12 patients (6%) required an operative revision due to early postoperative complications such as persistent pneumothorax, hemothorax and postoperative wound infection.

Conclusion: A single-incision VATS can be performed safely in different thoracic cases with a low postoperative complication rate. In our experience, we could expand the indications for a uniportal approach in clinical routine to almost all VATS procedures including lobectomies and other complex anatomical resections.