Uniportal lobectomy, subxiphoid approach

A uniportal subxiphoid lobectomy (using the Shanghai technique) was performed on a 62-year-old lifelong smoker male patient with a histological diagnosis of right middle lobe adenocarcinoma, measuring 1.5 cm and radiological staging of T1aN0M0. The operation was done successfully and the patient was discharged home two days later without any complications. In traditional video-assisted thoracic surgery (VATS) surgery, the instruments and the thoracoscope enter the thoracic cavity through 2 to 4 operating ports on the lateral chest wall, which can cause chronic pain and chest wall numbness. Single-portal VATS surgery could potentially cause similar problems as the port is placed in between the ribs. Liu et al . reported a subxiphoid uniportal VATS left upper lobectomy in August 2014. The advantage of the uniportal subxiphoid approach is the ability to use different size of instruments and freedom of movement as there is no limitation by the ribs. We have been performing microlobectomies in our institution (with the utility port placed in the subxiphoid region) and therefore technically similar to this approach.