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International Society For Minimally Invasive Cardiothoracic Surgery

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3-ports Vats Lobectomy Using Subxiphoid And Subcostal Space
Hyo Jun Jang, Hyuck Kim, Jun Ho Lee, Won-Sang Chung.
Hanyang University, Seoul, Korea, Republic of.

Background A patient with video assisted thoracoscopic surgery (VATS) might be suffered from chronic intercostal neuralgia. To reduce interocostal nerve injury, a novel thoracic approach using non-intercostal space has been developed. The aim of this study was to evaluate feasibility of novel approach. Methods A 54-years old male patient with suspicious lung cancer of right upper lobe underwent VATS lobectomy using subxiphoid and subcostal space. The patient was placed in a left lateral decubitus position slightly rotated posteriorly. 4cm midline subxiphoid incision and 1.5cm two subcostal incision were made. VATS RUL lobectomy and mediastinal lymph node dissection was completed. Results Total operation time was 210min including frozen pathologic delay. Total number of dissected lymph node was 25 including upper paratracheal, lower paratracheal and subcarinal lymph node. The patient was discharged at 4th postoperative day without any complication. Pathologic report was adenocarcinoma with T1cN0M0. Postoperative visual analogue scale was 0 at second outpatient clinic visit. Conclusions VATS lobectomy through subxiphoid and subcostal space is feasible.​ However, to ensure the real benefit of such approach, further study will be needed.


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