Flexible videoscope for thoracoscopic lobectomy: evolution of uniportal technique

Background: Over the years reducing the number of ports during Video-assisted thoracic surgery (VATS) has allowed to accomplish pulmonary lobectomy with a single incision. Endoscopic view and instruments maneuvers issues could be improved by using flexible endoscope. We report our experience of fifteen uniportal VATS (UVATS) using a flexible thoracoscope. Methods: A single incision of about 4–5 cm long was performed at the 5th intercostal space along the anterior axillary line. No additional skin incisions were made. A flexible videoscope and multiple VATS instruments were simultaneously inserted into the uniport. Pulmonary lobectomy with systematic mediastinal lymph node dissection was performed. Verbal pain scores were registered using the visual analog scale from 0 to 10 at the first post-operative day. Results: No post-operative complications or hospital mortality were recorded. Mean operative time was 112.6 min (range 70–200) and mean postoperative hospital stay 3.2 days (range 2–6). Mean pain score was 0.5 (range 0–2). Conclusions: Single-incision VATS lobectomy using a flexible thoracoscope is a feasible and safe approach.