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OBJECTIVE: VATS lobectomy is not new issue but the technique to perform it is still controversial especially the access incisions. The trend is getting smaller incisions and lesser entrance ports but enable surgeon to perform anatomical lobectomy. We present our experience using three entrance ports in which the max one is 2.5 cm
METHODS: We reviewed patients who underwent VATS lobectomy by the same surgeons during the time of 4 years (from Aug. 2009 to May. 2013). We access the lung by a 2.5 cm working incision and two other 10mm ports for scope and endoscopic instruments using exchangeable. Resected lobe(s) was (were) put in a plastic bag and taken out via working incision (without further incision).
RESULTS: The described incision and ports could access all aspects of the lung, enable surgeon to perform total endoscopic lobectomy and lymph nodes resection in 97 cases of VATS lobectomy. Of them, 2 had trivial bleeding that required chest tube for 4 days. No mortality. The main operation time is 150 minutes and the main post-op hospitalization is 6 days.
CONCLUSIONS: The above described incision and ports enable to performed total VATS lobectomy for lung tumor sized up to 7cm and complete lymp nodes resection in lung cancer staging up to 2B.