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Hidehiro Yamamoto, MD; Masayoshi Okada, MD; Masahiko Takada, MD; Hidehito Mastuoka, MD; Kouji Sakata, MD; Munenori Kawamura, MD

Arch Surg. 1998;133:145-147.

Objective  To develop a minimally invasive video-assisted thoracic surgery technique.

Design  Case series.

Setting  University referral center.

Patients  Six consecutive patients with a pneumothorax who underwent video-assisted thoracic surgery through a single skin incision.

Interventions  A flexible digital bronchoscope was placed in a scope guide. A single 2.0-cm skin incision was made in the midaxillary line. The entire lung was carefully explored. An endoscopic stapling device was then inserted, and the lung resection was performed through a single skin incision.

Primary Outcome Measures  Operative time, estimated amount of blood loss, operative complications, and postoperative air leakage were recorded.

Results  The video-assisted thoracic surgery procedure through a single incision was successful in all 6 patients. There were no associated complications at 1-year follow-up.

Conclusions  We were able to perform the video-assisted thoracic surgery procedure through a single skin incision using a scope guide and a flexible scope that enables visualization of the entire pleural cavity, providing even laser ablation. This new technique can be used to treat patients with pneumothoraces without the need for additional skin incisions.

From the Departments of Surgery, Kobe University School of Medicine (Drs Yamamoto, Okada, and Takada), Kanazawa Hospital (Drs Mastuoka and Sakata), and Kyouwa Hospital (Dr Kawamura), Kobe, Japan.

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