Re-thoracoscopic surgery for middle lobe torsion after right upper lobectomy.

After pulmonary resection, lobar torsion is a rare but potentially serious complication. The reported occurrence rate is 0.089-0.3%. Generally, management for this condition is exploration through 'open technique' thoracotomy with the resection of the affected lobe. A 68-year old male was diagnosed with right middle lobe torsion 1 day after a video-assisted thoracoscopic (VATS) right upper lobectomy. A second VATS right middle lobectomy was successfully performed through the same incisions. The careful follow-up and the prompt detection of lobar torsion using the VATS approach lead to a satisfactory outcome.