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International Society For Minimally Invasive Cardiothoracic Surgery

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Uniportal Vats: From 2% To 74% Of Anatomic Lung Resections In 4 Years.
Aleksandra Chrzastek, Przemyslaw Blawat, Maciej Dancewicz, Lukasz Zolna, Mariusz Bella, Aleksandra Burysz, Blazej Przybyslawski, Janusz Kowalewski, Prof
Oncology Centre, Bydgoszcz, Poland, Bydgoszcz, Poland

Background Uniportal video-assisted thoracic surgery (VATS) has revolutionized the way thoracic surgeons treat pulmonary lesions. The aim of the present study was to investigate the implementation of this technique at our Clinic.
Methods We evaluated each major pulmonary resection performed by uniportal VATS between January 1, 2016 and December 31, 2019. The analyzed parameters included type of the procedure, its length, patientís blood loss, oncological radicality and the number of lymph nodes dissected.
Results
In 2016 we performed 2% (3) of all major anatomical resections (132) by uniportal VATS with no conversions. In 2017- 33% (43 out of 129) with conversion rate 18,6%. In 2017, this technique was used in 33% (43 out of 129) of cases. In 2018- 50% (65 out of 130) with conversion rate 21,5%. Within four years of experience and obstinacy we reached 74% of major resections done by uniportal VATS with conversion rate 9,8%. For us the most important factor was one consultant surgeon trained abroad and then firstly performing uniportal VATS resections with young surgeons assisting. After couple of months residents started uniportal VATS resections with supervision of more experienced consultant surgeon. We start almost every surgery by uniportal VATS, and decided after quick evaluation if we are able to do the procedure. It is important to learn how to deal with complications in uniportal VATS.
Conclusions Uniportal VATS is a feasible and safe technique with great benefits. Herein, we suggest in details how to apply it into the surgical practice.


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