Uniportal thoracoscopic lobectomy for intralobar pulmonary sequestration

Abstract

Pulmonary sequestration is an uncommon congenital condition for which surgical resection is usually indicated – either via open thoracotomy or conventional multi-port video-assisted thoracoscopic surgery (VATS). Of the two types of sequestration, intralobar sequestration is technically more challenging to resect. We report the first case to our knowledge in which a uniportal VATS approach was used to perform a lobectomy for intralobar pulmonary sequestration. The uniportal approach is the latest, most minimally invasive technique for ultra-major thoracic surgery, but experience with its use in complex congenital pulmonary disease has thus far been limited. The patient was a 34 year old adult male with a long history of symptoms, an extensively diseased right lower lobe, and three separate anomalous feeding vessels arising from the abdominal aorta. Uniportal right lower lobectomy was performed via only a 3.5 cm incision. The patient recovered well, was fully mobile from the morning after surgery, and was discharged home on the fourth post-operative day. This case demonstrates the safety and feasibility of the uniportal approach even for the resection of a relatively challenging intralobar sequestration. Our video shows all the key features of the operation, with clear demonstration of the steps involved.