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J Thorac Cardiovasc Surg 2006;132:464-465
© 2006 The American Association for Thoracic Surgery

Editorial

Thoracoscopic lobectomy: Evolving and improving

Department of Surgery, Duke University Medical Center, Durham, NC.

Received for publication April 19, 2006; accepted for publication April 24, 2006.

^_* Address for reprints: Thom A. D'Amico, MD, Associate Professor of Surgery, Duke University Medical Center, Box 3496, Durham, NC 27710 (Email: damic001@mc.duke.edu).

The first 20% of the full text of this article appears below.

Thoracoscopic lobectomy, also termed video-assisted thoracoscopic (VATS) lobectomy, has been demonstrated to be a safe and effective procedure to treat early-stage non–small cell lung cancer (NSCLC). Advantages of thoracoscopic lobectomy, as compared with lobectomy with thoracotomy, include less postoperative pain, faster return to full activity, preserved pulmonary function, shorter chest tube duration and length of hospitalization, reduced inflammatory response, and a lower rate of postoperative atrial fibrillation.^1,2

Despite these advantages, thoracoscopic lobectomy has not achieved the expected widespread acceptance seen with other minimally invasive procedures. One important obstacle to the development of this procedure has been confusion regarding the technical aspects of the procedure—the attachment of the term "VATS lobectomy" to a number of procedures with varying degrees of invasiveness and oncologic effectiveness. Thoracoscopic lobectomy should be defined as a completely thoracoscopic procedure performed with a limited number of ports (one or two) and an access incision (approximately 5 cm in length) for individual vessel and bronchial dissection and ligation (stapling), as well as specimen removal.³ Importantly, rib spreading with retractors is not used. "Video-assisted" procedures that include thoracotomy with rib spreading . . . [Full Text of this Article]

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