[Approaches and results in video-assisted thoracic surgery lobectomy for the patient with primary lung cancer].

Video-assisted thoracic surgery (VATS) lobectomy is defined as a video-assisted procedure using anatomic dissection with individual ligation of the vessels and bronchi. VATS lobectomy can offer several advantages, including decreased pain, and decreased inflammatory response. The patient is placed in the lateral decubitus position. A 12-mm port is inserted in the 7th intercostal space at the midaxillary line. A 8-cm utility incision is created in the axilla at the 4th intercostal space for upper or middle lobectomy. For lower lobectomy, a 8-cm utility incision is created in the auscultatory triangle at the 5th intercostal space. A 12-mm incision is frequently placed near the utility incision in the 6th intercostal space, particularly when using retraction for improved exposure or for insertion of added instrumentation. We performed the hilar vessel ligation using endoscopic ligation forceps SAITO model (Japan patent no. 4148324). We reported approaches and techniques in our hospital for the patients who underwent VATS lobectomy based on the surgical databases from the Division of Thoracic Surgery at the Kansai Medical University Hirakata Hospital during the period from January 5, 2006 through August 31, 2008.