The Era of VATS Lobectomy

Primary lung cancer remains the most lethal of all malignancies. The cornerstone of therapy for early-stage non-small cell lung cancer (NSCLC) is surgical resection by lobectomy with complete systematically lymphadenectomy (Hartwig & D’Amico, 2010). One of the initial reports on video-assisted thoracoscopic lobectomy was published 1994 by Robert McKenna (McKenna, 1994). Since then thoracoscopic techniques to perform major anatomic lung resections evolved dramatically and have gained widespread adoption. But in fact, worldwide only 20% of all lobectomies are done using a thoracoscopic approach (Buffa et al., 2008). Germany Advantages of thoracoscopic lobectomy compared to open thoracotomy include a lower incidence of complications (Paul et al., 2010), shorter hospitalization (Scott et al., 2010), better pulmonary function (Kaseda et al., 2000), less postoperative pain (McKenna et al. 2006), decreased overall costs (Burfeind et al., 2010; Casali & Walker, 2009) and improved delivery of adjuvant chemotherapy to selected patients (Lee at al., 2011; Petersen et al., 2007). These outcomes suggest that thoracoscopic lobectomy should be considered the gold standard for patients with early-stage NSCLC (Hartwig & D’Amico 2010).