Surgical Endoscop

, Volume 11, Issue 4, pp 354–358

Fully thoracoscopic pulmonary lobectomy and specimen extraction through rib segment resection

Preliminary report
  • E. C.  Poulin
  • R.  Labbé

DOI: 10.1007/s004649900362

Cite this article as:
Poulin, E. & Labbé, R. Surg Endosc (1997) 11: 354. doi:10.1007/s004649900362


Background: A technique of fully thoracoscopic pulmonary lobectomy with rib-segment resection for specimen extraction is described, and preliminary results in 18 patients are presented.

Methods: Surgery is performed through four 15-mm ports. For all lobes except one, the surgeon operates in front of the patient, where the rib spaces are widest and rib-space trauma is less. When lobar dissection is complete, specimen extraction is performed after resection of a rib segment proportional to tumor size. Muscle section is kept to a minimum. There is no rib retraction.

Results: There were no deaths, three conversions to open surgery, and three major complications. Average postoperative stay was 5.4 days for patients without complications and 9.6 days for patients with complications. In total six patients presented with some degree of air leaks, and two had post-thoracotomy pain (>2 month's duration). The literature is reviewed to analyze current techniques and to define parameters of a truly minimally invasive pulmonary lobectomy.

Conclusions: This technique is safe and promising; however, thoracoscopic lobectomy still needs refining. Before valid randomized studies comparing thoracoscopic lobectomy and muscle-sparing thoracotomy or posterolateral thoracotomy can be credible, technical issues related to the production of a truly minimally invasive procedure should be resolved.

Key words: Thoracoscopy — Pulmonary lobectomy — VATS lobectomy

Copyright information

© Springer-Verlag New York Inc. 1997

Authors and Affiliations

  • E. C.  Poulin
    • 1
  • R.  Labbé
    • 1
  1. 1.Department of Surgery, Hôpital du Saint-Sacrement, Université Laval, 1050 Chemin Ste-Foy, Québec, QC, Canada G1S 2L6 Canada