Geometrical characteristics of uniportal VATS.

TLDR

Uniportal VATS resections are comparable in accuracy and efficacy to standard VATS, yet standard three‑port VATS suffers from geometric interference that limits the flat two‑dimensional vision. The study aims to assess the advantages of a single‑port VATS approach, including reduced postoperative pain from a single intercostal incision and a translational instrument approach along a sagittal plane. By enabling instruments to draw two parallel lines on the surgical plane, the uniportal approach provides a caudo‑cranial perspective and a projective plane for lesion targeting. This geometry allows the surgeon to position the operative fulcrum inside the chest, enabling lesion access similar to open surgery.

Abstract

In terms of accuracy and efficacy Uniportal Video-Assisted Thoracic Surgery (VATS) resections are comparable to standard VATS. In standard three-ports VATS, the geometric configuration of a parallelogram generates interference with the optical source, creating a plane with a torsion angle not favorable on the flat two-dimensional vision of currently available monitors. The potential advantages of single-port VATS approach include not only the one intercostal space incision (reduction of postoperative pain) but also a translational approach of VATS instruments along a sagittal plane. Accordingly, the Uniportal approach enables VATS instruments to draw two parallel lines on the plane, bringing them to approach the target lesion from a caudo-cranial perspective thus achieving a projective plane. As a consequence, taking advantage of the unique spatial features specific to uniportal VATS, the surgeon is enabled to bring the operative fulcrum inside the chest to address the target lesion in a fashion similar to open surgery.