Technical aspects of uniportal video-assisted thoracoscopic double sleeve bronchovascular resections

Diego Gonzalez-Rivas, Alejandro Garcia, Chang Chen, Yang Yang, Lei Jiang, Dmitrii Sekhniaidze, Gening Jiang, Yuming Zhu

Research output: Contribution to journalReview articlepeer-review

Abstract

Double sleeve, bronchial and vascular reconstructions are challenging procedures indicated for centrally located tumours to avoid pneumonectomy. Traditionally, these resections have been performed by thoracotomy, but thanks to advances in imaging systems, better surgical instruments and the gained experience in video-assisted thoracic surgery (VATS), the scenario now is different. During the last decade, we have seen a rapid evolution of the uniportal VATS technique from simple lobectomies to advanced double sleeve bronchovascular procedures and carinal resections. The advantages of VATS over open surgery for major lung resections in terms of postoperative pain and morbidity, length of hospital stay and quality of life have prompted experienced surgeons to adopt uniportal VATS for cases requiring a sleeve resection. However, when a double bronchial and vascular sleeve resection is required, the adoption rate of minimally invasive surgery is still very low even for very experienced VATS surgeons. The difficulty of tumour mobilization, complexity of the suturing technique and the concern about possible uncontrolled massive bleeding during VATS are the main reasons for this low rate of adoption. In this article, we describe the technical aspects and tricks of this procedure when it is done by the uniportal VATS approach.

Original languageEnglish (US)
Pages (from-to)I14-I22
JournalEuropean Journal of Cardio-thoracic Surgery
Volume58
DOIs
StatePublished - Aug 1 2020
Externally publishedYes

Keywords

  • Advanced videoassisted thoracic surgery
  • Bronchoplasty
  • Bronchovascular reconstruction
  • Double sleeve
  • Uniportal sleeve
  • Vascular sleeve

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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