Skip to main content


Log in

Flexible videoscope for thoracoscopic lobectomy: evolution of uniportal technique

  • Technique
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript



Over the years reducing the number of ports during Video-assisted thoracic surgery (VATS) has allowed to accomplish pulmonary lobectomy with a single incision. Endoscopic view and instruments maneuvers issues could be improved by using flexible endoscope. We report our experience of fifteen uniportal VATS (UVATS) using a flexible thoracoscope.


A single incision of about 4–5 cm long was performed at the 5th intercostal space along the anterior axillary line. No additional skin incisions were made. A flexible videoscope and multiple VATS instruments were simultaneously inserted into the uniport. Pulmonary lobectomy with systematic mediastinal lymph node dissection was performed. Verbal pain scores were registered using the visual analog scale from 0 to 10 at the first post-operative day.


No post-operative complications or hospital mortality were recorded. Mean operative time was 112.6 min (range 70–200) and mean postoperative hospital stay 3.2 days (range 2–6). Mean pain score was 0.5 (range 0–2).


Single-incision VATS lobectomy using a flexible thoracoscope is a feasible and safe approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Roviaro G, Rebuffat C, Varoli F, Vergani C, Mariani C, Maciocco M (1992) Videoendoscopic pulmonary lobectomy for cancer. Surg Laparosc Endosc 2:244–247

    CAS  PubMed  Google Scholar 

  2. Gonzalez-Rivas D, Paradela M, Fernandez R, Delgado M, Fieira E, Mendez L, Velasco C, de la Torre M (2013) Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg 95(2):426–432

    Article  PubMed  Google Scholar 

  3. Hanna JM, Berry MF, D’Amico TA (2013) Contraindications of video-assisted thoracoscopic surgical lobectomy and determinants of conversion to open. J Thorac Dis 5(Suppl 3):S182–S189

    PubMed Central  PubMed  Google Scholar 

  4. Ferguson J, Walker W (2006) Developing a VATS lobectomy programme - can VATS lobectomy be taught? Eur J Cardiothorac Surg 29(5):806–809

    Article  PubMed  Google Scholar 

  5. Andreetti C, Menna C, Ibrahim M, Ciccone AM, D’Andrilli A, Venuta F, Rendina EA (2014) Postoperative pain control: videothoracoscopic versus conservative mini-thoracotomic approach. Eur J Cardiothorac Surg Mar 18 [Epub ahead of print]

  6. Ibrahim M, Menna C, Andreetti C, Ciccone AM, D’Andrilli A, Maurizi G, Pomes LM, Cassiano F, Venuta F, Rendina EA (2013) Bilateral single-port sympathectomy: long-term results and quality of life. Biomed Res Int 2013:348017

    PubMed Central  PubMed  Google Scholar 

  7. Gonzalez-Rivas D (2012) VATS lobectomy: surgical evolution from conventional VATS to uniportal approach. Sci World J 2012:780842

    Article  Google Scholar 

  8. Licht PB, Ladegaard L (2010) Flexible thoracoscopy may facilitate video-assisted thoracoscopic lobectomy. World J Surg 34(7):1470–1474

    Article  PubMed  Google Scholar 

  9. D’Andrilli A, Ibrahim M, Ciccone AM, Venuta F, De Giacomo T, Massullo D, Pinto G, Rendina EA (2006) Intrapleural intercostal nerve block associated with mini-thoracotomy improves pain control after major lung resection. Eur J Cardiothorac Surg 29(5):790–794

    Article  PubMed  Google Scholar 

  10. Tam JK, Lim KS (2013) Total muscle-sparing uniportal video-assisted thoracoscopic surgery lobectomy. Ann Thorac Surg 96(6):1982–1986

    Article  PubMed  Google Scholar 

  11. Jutley RS, Khalil MW, Rocco G (2005) Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg 28(1):43–46

    Article  PubMed  Google Scholar 

  12. Rocco G, Martucci N, Setola S, Franco R (2012) Uniportal video-assisted thoracic resection of a solitary fibrous tumor of the pleura. Ann Thorac Surg 94(2):661–662

    Article  PubMed  Google Scholar 

Download references


We wish to thank Dr. M. Silvi for data management and editorial assistance.


Drs. Mohsen Ibrahim, Cecilia Menna, Claudio Andreetti, Antonio D’Andrilli, Anna Maria Ciccone, Giulio Maurizi, Francesco Cassiano and Erino Angelo Rendina have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Mohsen Ibrahim.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ibrahim, M., Menna, C., Andreetti, C. et al. Flexible videoscope for thoracoscopic lobectomy: evolution of uniportal technique. Surg Endosc 29, 2056–2059 (2015).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: