Uniportal thoracoscopic lateral and posterior basal segmentectomy using intersegmental tunneling: Comparison with multiportal approach.

Thoracoscopic lateral and posterior basal (S9 + 10) segmentectomy (or S10 segmentectomy) is one of the most technically challenging anatomical segmentectomies. We have used "intersegmental tunneling" in the multiportal approach, and we now apply this with a little ingenuity in the uniportal approach. However, because of interference between instruments and the limited insertion angles in the uniportal approach, complex segmentectomies such as S9 + 10 or S10 become even more difficult. The perioperative outcomes were compared between uniportal and multiportal thoracoscopic lateral and posterior basal segmentecomy using intersegmental tunneling. There were no significant differences between the groups in patient characteristics and perioperative outcomes other than operation time, which was significantly shorter in the uniportal group than in the multiportal group (169 ± 21 vs 216 ± 34 min, P = .011). Thoracoscopic S9 + 10 (S10) segmentectomy can be safely performed through the uniportal approach without any difficulties using an intersegmental tunneling method and adding a little ingenuity.