Video thoracoscopic lobectomy. Surgical technique and results

: For a variety of indications, thoracoscopic surgery has become established as a safe and effective alternative to open thoracotomy. Improvements in video technology and the development of instruments for thoracoscopic surgery now make it possible to perform lobectomies. In this paper the surgical technique of thoracoscopic lobectomy is described, and surgical and functional results are analysed. Since January 1993, in 38 of 47 patients who underwent endoscopic surgery, thoracoscopic lobectomy was possible. In 9 cases (19.1%) a change to open surgery was indicated for technical and oncological reasons. There were 24 males and 14 females between the ages of 7 and 82 years (average age of 58.5 years). The indications were benign pulmonary disease in 10 cases and non-small-cell lung cancer (stage I) in 28 cases. Four trocars were inserted; the pulmonary arteries and veins, the bronchi and the interlobar fissures were closed and divided with endoscopic staplers. There were neither intraoperative complications nor postoperative deaths. The rate of postoperative complications was very low. Patients benefited from the short hospital stay, limited postoperative pain, excellent early pulmonary function and fast recovery time. We conclude that for selected indications thoracoscopic lobectomies are safe and effective, but further studies are necessary to determine the true merits of the procedure.