Uniportal video-assisted thoracoscopic surgery for anatomical fissureless anterior segment resection (S3) of the right upper lobe followed by lymph node dissection.

Uniportal video-assisted thoracoscopic (UVATS) resections seem to offer real benefits over conventional surgery in terms of postoperative pain and better cosmetic results.  The procedure described in this tutorial, an anterior segment resection of the right upper lobe, is rarely performed, and fissureless resection of this segment by means of UVATS has, at time of writing, never been described in the literature.  Our patient was a 79-year-old female, admitted to our clinic for treatment of a solitary metachronous metastatic tumor of a colon carcinoma, located in the anterior segment of the right upper lobe. A fissureless anatomical anterior segment resection of the right upper lobe was conducted, followed by the radical lymph node dissection.  The postoperative course was event free and the patient was discharged on the 4th postoperative day. Fissureless VATS operations have an advantage compared to conventional operations in terms of reduced risk of prolonged air leak. Moreover, these operations take no longer to perform than conventional surgery and have no notable disadvantages, apart from the potential for using more staples.