Lobectomia superior derecha toracoscopica single port con reseccion de pared costal

Cancer de pulmon con invasion de pared costal. Recibio quimioterapia de induccion con buena respuesta. El paciente fue intervenido mediante toracoscopia single port para la lobectomia superior derecha y mediante una incision posterior subescapular y bajo visión toracoscopica se realizo la reseccion costal (lobectomia con la reseccion de pared en bloque). Single-incision VATS lobectomy follows the oncological principles of major pulmonary resections by VATS: individual dissection of veins, arteries and lobar bronchus, likewise complete mediastinal lymphadenectomy with a video-assisted thoracoscopic approach, with no rib spreading. Video assisted thoracoscopic lobectomy with chest wall resection is usually performed by thoracotomy. This video shows a minimal invasive technique for chest wall resection and uniportal VATS upper lobectomy.A 57 year-old nonsmoker male was proposed for a right upper lobe adenocarcinoma surgery. A CT scan revealed a 3.6cm adenocarcinoma in right upper lobe (RUL) with chest wall involvement. After induction therapy the patient was proposed for surgery. The patient was placed in a left lateral decubitus position. A VATS approach trough a single 4 cm incision was made in the 5th intercostal space with no rib spreading Assesment of RUL with chest wall involvement was detected. A posterior subescapular incision was performed to resect 4º and 5º posterior rib under toracoscopic vision. After chest wall resection a right upper lobectomy with lymphadenectomy was performed by single-incision approach and a single chest tube was placed trough the incision. The pathological examination revealed a 3.3cm primary lung adenocarcinoma with rib affection but no lymph node involvement.ç Diego Gonzalez Rivas, MD, FECTS Coruña Hospital, Coruña, Spain Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain http://www.videothoracoscopy.com http://www.videocirugiatoracica.com/sp/ http://uniportalvats.blogspot.com.es/