One Stage Minimally Invasive Thoracoscopic Lung Resection and Transphrenic Adrenalectomy

Surgery may offer a long-term survival benefit to a small proportion of patients with operable non-small cell lung cancer (NSCLC) and solitary adrenal metastasis. Several approaches to lung resection with a separate open or laparoscopic adrenalectomy have been advocated. We present a technique that allows a single incision, single operation through a transdiaphragmatic approach to the ipsilateral adrenal gland following lung resection through a video assisted thoracic surgery (VATS) approach. By using this approach, along with an advanced bipolar device to aid adrenal dissection and clip-less vessel closure, both lobectomy and adrenalectomy can be carried out safely and effectively with minimal perioperative and postoperative morbidity.