Shenzhen People's Hospital, Second Affiliated Hospital, Medical College of Ji'nan University, Shenzhen 518020, China.
J Thorac Dis. 2013 Dec;5(6):875-81. doi: 10.3978/j.issn.2072-1439.2013.11.04.
The video-assisted thoracoscopic approach (VATS) for lobectomy of non-small-cell lung cancer (NSCLC) has not been standardized. Although three to four incisions are usually made, with the right surgical technique, the operation can be successfully carried out via only two incisions. This video demonstrates a case undergoing biportal complete VATS (biportal cVATS) right upper lobectomy and systematic lymphadenectomy. Here we describe our technique of biportal approach by using a combination of conventional and endoscopic instruments. As our experience gained, we consider the knacks of biportal cVATS lobectomy imply two radical changes of perspectives from the traditional triportal technique. One fundamental step is how to achieve satisfactory exposure in the case of single utility incision for multiple instruments to insert. Another technical tip that should be taken into account is how to introduce staplers conveniently without the third posterior port. Optimization of the whole procedures is critical for accomplishing anatomic hilar vascular, bronchial, and lymphatic dissection via two ports. In conclusion, biportal cVATS lobectomy for lung cancer is a safe and reliable procedure that can achieves good postoperative results without oncological compromise.
视频辅助胸腔镜手术（VATS）用于非小细胞肺癌（NSCLC）的肺叶切除术尚未标准化。尽管通常需要做三个或四个切口，但如果采用正确的手术技术，手术可以仅通过两个切口成功进行。本视频演示了一例经双端口完全 VATS（双端口 cVATS）右肺上叶切除术和系统淋巴结清扫术。在此，我们描述了使用传统和内镜器械相结合的双端口入路技术。随着经验的积累，我们认为双端口 cVATS 肺叶切除术的诀窍在于从传统的三端口技术转变两个基本观点。一个基本步骤是如何在单个器械插入的单一实用切口的情况下实现满意的暴露。另一个需要考虑的技术要点是如何在没有第三个后端口的情况下方便地引入吻合器。优化整个手术过程对于通过两个端口完成解剖性肺门血管、支气管和淋巴结的解剖至关重要。总之，双端口 cVATS 肺癌肺叶切除术是一种安全可靠的手术方法，可以在不影响肿瘤学效果的情况下获得良好的术后结果。
