From open to single port video-assisted thoracoscopic lobectomy: a stepwise and return progression of the experience from Department of Thoracic Surgery, General Hospital of Guangzhou Military Command of P.L.A

Department of Thoracic Surgery, General Hospital of Guangzhou Military Command of P.L.A was founded in 1954, and the first lobectomy using standard posterolateral thoracotomy was performed in the same year. For about half a century, more than 5,000 open lobectomy have been performed at the department. With the wide acceptance of video assisted thoracoscopic surgery (VATS) lobectomy all over the world, more than a thousand cases of multiport VATS lobectomy have been performed at our department. Since 2013, without any training and operation observation, single port VATS lobectomy has been successfully developed after the reading of a series of papers by Dr. Gonzalez-Rivas, and nearly 200 single port VATS lobectomy have been performed at our department up to now. Moreover, we have developed our own unique surgical skills and process without any major intra-/and post-operative complications. In order to verify the advantages of single port, we launched a prospective study to compare the short and long term outcomes between multiple and single port VATS lobectomy recently. Here, we firstly introduce the evolution of lobectomy approach at our department, and give the story how we develop surgical approach from open to single port VATS step by step. Then, the characteristic of single port lobectomy and our unique experience will be described. We think single port VATS lobectomy is a kind of return progression from open lobectomy with the same surgical vision and technique maneuver. At last, we will discuss a few potential improvements of single port lobectomy and give a glimpse into the future.