Video-assisted thoracic surgery micro pneumonectomy, a new approach.

ElSaegh, Mohamed Moneer; Ismail, Nur Aziah; Gordon, Jacqueline; Khan, Iqbal; Jones, Richard; Calvert, Rachel; Connelly, Leanne; Dunning, Joel

Background Video-assisted thoracic surgery (VATS) pneumonectomy is normally limited due to the difficulty to remove the whole lung via the utility incision. We present our technique of VATS pneumonectomy, this we call micropneumonectomy. Methods A 75-year-old male current smoker with a right hilar mass, invading both upper and lower lobe bronchi to segmental level on CT scan and PET scan, pathology from CT guided biopsy showed squamous cell carcinoma. The patient had a mediastinoscopy just prior to pneumonectomy, primarily to remove station 7 lymph nodes and to mobilize the carina to facilitate the VATS pneumonectomy. Results Smooth postoperative course, and patient was fit for discharge two and half days post operatively. Conclusions Our technique showed an effective way of doing pneumonectomy via VATS technique, which expands the use of VATS technique into pneumonectomies, with three intercostals incisions smaller than 5 mm, in addition to a single sub-xiphoid incision which can take 12 mm instruments.