Single-port thoracoscopic lung surgery without intubation

Video surgery, a thoracic surgery technique, considerably improves the results with respect to classic surgery and the recovery is faster and less painful.

Thanks to advances in medicine in prevention, early diagnosis and new surgical techniques, lung tumors can nowadays, when detected in time, be curable.

Lung cancer can be operated on in two ways. The classic way is open surgery, also called thoracotomy, in which a 15-20 cm incision is made and the ribs are separated. This approach has a very painful postoperative period and has nowadays been replaced by thoracoscopic techniques in many centers.

The least aggressive approach and the one that offers the best results is video surgery, also called VATS. In this procedure, one to three small incisions are made and the operation is performed through high resolution video cameras. By not separating the ribs, recovery is much better.

Our group was a pioneer in the world of single incision video surgery, performing the first case in 2010. Since then we have performed more than 1,000 uniportal procedures and more than 600 major procedures with this technique, including very complex cases.

Since 2014 we have gone a step further to reduce surgical aggression by developing lung surgery with the patient unintubated, under sedation and maintaining spontaneous ventilation, which is less invasive and less disruptive to immunity. To date we have performed more than 30 lobectomies using this technique with excellent postoperative results.

The advantages of this new advance are multiple. The adverse effects of tracheal intubation and the use of general anesthesia, such as intubation-related trauma, ventilation-induced lung injury, neuromuscular block, reduced cardiac function, nausea and vomiting, are minimized. In addition, as it is a minimally invasive technique with a single incision, hospital stay is reduced and patient recovery is much faster.

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It is important to point out that the use of this technique also makes it possible to operate on patients whose state of health makes it impossible to administer general anesthesia or on elderly patients. This new form of intervention is a safe option for them.