Reduced complexity of uniportal video-assisted thoracoscopic left upper sleeve lobectomy

In recent years improvements in thoracoscopic instrumentation and technology including high definition cameras and miniaturized energy devices have led to uniportal video-assisted thoracoscopic (VATS) lobectomy becoming more common (1). However, uniportal VATS sleeve lobectomy (SL) is more difficult, and the competence threshold for performing such surgery is high, so only a small number of expert VATS surgeons have mastered it (2). Furthermore, the left upper SL is usually more complicated due to the presence of the aortic arch, the bigger size of the pulmonary artery and absence of the intermediate bronchus (3). In this article, we describe improvements to bronchial exposure and simplification of the anastomosis technique with existing equipment which reduces the complexity of uniportal VATS left upper SL.