Transaxillary uniportal video assisted thoracoscopic surgery for right upper lobectomy

Uniportal video-assisted thoracic surgery (VATS) was growing popular since its first introduction. Based on the conventional uniportal VATS, we modified the technique and introduced transaxillary uniportal VATS lobectomy in this case report. In March 2017, transaxillary uniportal VATS was firstly attempted on a patient suffering from right upper lobe lesion at the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University. A 4-cm single incision was made at the fossa axillaris paralleled to the skin folds, to which a soft wound protector was applied to reach the third intercostal space along the anterior axillary line. The right upper lobectomy was performed through the transaxillary incision. The surgery was accomplished without conversion to thoracotomy or application of extra incision. The truncus anterior artery, the upper lobe bronchus and upper pulmonary vein was mobilized and dissected in order. The target lobe was removed through the fossa axillaris incision. The operation duration was 110 minutes with limited blood loss. The patient was discharged 3 days post-operatively. Transaxillary uniportal VATS lobectomy is safe and feasible, and the procedure showed cosmetic advantages. Further studies based on larger population are required to determine these findings.