Uniportal Video-Assisted Thoracoscopic Sleeve Resections

  • Diego Gonzalez-RivasEmail author
  • Jiang Lei
  • Dmitrii Sekhniaidze


In 1947 the first bronchoplasty took place to remove a benign tumor [1]. Thereafter, in 1959 the first bronchial carcinoma was removed [2]. A right pneumonectomy with en-bloc resection of the carina was reported in 1950 [3]. Gibbon described in 1959 the first case of a right sleeve pneumonectomy [4] and in the eighties decade, Grillo and coworkers described carinal resections [5]. Pulmonary artery reconstruction for lung cancer was reported in 1950. During the 1970s and 1980s a few groups also described these procedures in a series of cases [6].


Sleeve lobectomy Bronchoplasty Vascular reconstruction Carinal resection Uniportal VATS Tracheal resection 

Supplementary material

Video 1

Right upper sleeve lobectomy (two running sutures) (M4V 562091 kb)

Video 2

Right upper sleeve lobectomy (one running suture, one thread with two needles) (MOV 150664 kb)

Video 3

Double sleeve left upper lobectomy (MP4 673634 kb)

Video 4

Right lower lobe sleeve resection (MP4 114274 kb)

Video 5

Right lower and middle lobe sleeve resection (MOV 1168238 kb)

Video 6

Left upper sleeve resection (one running suture, one thread with two needles) (MOV 1947051 kb)

Video 7

Left lower sleeve lobectomy (MOV 1488989 kb)

Video 8

Lingular sleeve segmental resection (MP4 691766 kb)

Video 9

Carinal sleeve resection (no lung resection) (MP4 116094 kb)


  1. 1.
    Price-Thomas C. Conservative resection of the bronchial tree. J R Coll Surg Edinb. 1956;1:169.Google Scholar
  2. 2.
    Allison PR. Course of thoracic surgery in Groningen. Quoted by Jones PH. Lobectomy and bronchial anastomosis in the surgery of bronchial carcinoma. Ann R Coll Surg Engl. 1959;25:20–38.Google Scholar
  3. 3.
    Abbott OA. Experiences with the surgical resection of the human carina, tracheal wall, and contralateral bronchial wall in cases of right total pneumonectomy. J Thorac Surg. 1950;19:906–22.PubMedGoogle Scholar
  4. 4.
    Gibbon JH, in discussion to Chamberlain M, et al. Bronchogenic carcinoma: an aggressive surgical attitude. J Thorac Cardiovasc Surg. 1959;38:727.Google Scholar
  5. 5.
    Grillo HC. Carinal reconstruction. Ann Thorac Surg. 1982;34:356–73.CrossRefGoogle Scholar
  6. 6.
    Vogt-Moykopf I, Fritz T, Meyer G, Bülzerbruck H, Daskos G. Bronchoplastic and angioplastic operation in bronchial carcinoma: long-term results of a retrospective analysis from 1973 to 1983. Int Surg. 1986;71:211–20.PubMedGoogle Scholar
  7. 7.
    Yan TD, Black D, Bannon PG, McCaughan BC. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol. 2009;27:2553–62.CrossRefGoogle Scholar
  8. 8.
    Onaitis MW, Petersen RP, Balderson SS, Toloza E, Burfeind WR, Harpole DH Jr, et al. Thoracoscopic lobectomy is a safe and versatile procedure: experience with 500 consecutive patients. Ann Surg. 2006;244:420–5.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Kaseda S, Aoki T, Hangai N, Shimizu K. Better pulmonary function and prognosis with video-assisted thoracic surgery than with thoracotomy. Ann Thorac Surg. 2000;70:1644–6.CrossRefGoogle Scholar
  10. 10.
    Yang X, Wang S, Qu J. Video-assisted thoracic surgery (VATS) compares favorably with thoracotomy for the treatment of lung cancer: a five-year outcome comparison. World J Surg. 2009;33:1857–61.CrossRefGoogle Scholar
  11. 11.
    Ng CS, Wan S, Hui CW, Lee TW, Underwood MJ, Yim AP. Video-assisted thoracic surgery for early stage lung cancer – can short-term immunological advantages improve long-term survival? Ann Thorac Cardiovasc Surg. 2006;12:308–12.PubMedGoogle Scholar
  12. 12.
    Maurizi G, D’Andrilli A, Anile M, Ciccone AM, Ibrahim M, Venuta F, et al. Sleeve lobectomy compared with pneumonectomy after induction therapy for non-small-cell lung cancer. J Thorac Oncol. 2013;8:637–43.CrossRefGoogle Scholar
  13. 13.
    De Leyn P, Rots W, Deneffe G, Nafteux P, Coosemans W, Van Raemdonck D, et al. Sleeve lobectomy for non-small cell lung cancer. Acta Chir Belg. 2003;103:570–6.CrossRefGoogle Scholar
  14. 14.
    Krüger M, Uschinsky K, Hässler K, Engelmann C. Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies. Eur J Cardiothorac Surg. 1998;14:46–52.CrossRefGoogle Scholar
  15. 15.
    Ng CS. Thoracoscopic sleeve resection-the better approach? J Thorac Dis. 2014;6:1164–6.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Gonzalez-Rivas D, Fernandez R, Fieira E, Rellan L. Uniportal video-assisted thoracoscopic bronchial sleeve lobectomy: first report. J Thorac Cardiovasc Surg. 2013;145:1676–7.CrossRefGoogle Scholar
  17. 17.
    Gonzalez-Rivas D, Delgado M, Fieira E, Pato O. Left lower sleeve lobectomy by uniportal video-assisted thoracoscopic approach. Interact Cardiovasc Thorac Surg. 2014;18:237–9.CrossRefGoogle Scholar
  18. 18.
    Bertolaccini L, Rocco G, Viti A, Terzi A. Geometrical characteristics of uniportal VATS. J Thorac Dis. 2013;5:214–6.Google Scholar
  19. 19.
    Bertolaccini L, Viti A, Terzi A. Ergon-trial: ergonomic evaluation of single-port access versus three-port access video-assisted thoracic surgery. Surg Endosc. 2015;29:2934–40.CrossRefGoogle Scholar
  20. 20.
    Nakagawa T, Chiba N, Ueda Y, Saito M, Sakaguchi Y, Ishikawa S. Clinical experience of sleeve lobectomy with bronchoplasty using a continuous absorbable barbed suture. Gen Thorac Cardiovasc Surg. 2015;63(11):640–3.CrossRefGoogle Scholar
  21. 21.
    Gonzalez-Rivas D, Fieira E, De la Torre M, Delgado M. Bronchovascular right upper lobe reconstruction by uniportal video-assisted thoracoscopic surgery. J Thorac Dis. 2014;6:861–3.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Gonzalez-Rivas D, Delgado M, Fieira E, Mendez L. Single-port video-assisted thoracoscopic lobectomy with pulmonary artery reconstruction. Interact Cardiovasc Thorac Surg. 2013;17:889–91.CrossRefGoogle Scholar
  23. 23.
    Yu DP, Han Y, Zhao QY, Liu ZD. Pulmonary lobectomy combined with pulmonary arterioplasty by complete video-assisted thoracic surgery in patients with lung cancer. Asian Pac J Cancer Prev. 2013;14:6061–4.CrossRefGoogle Scholar
  24. 24.
    Nakanishi R, Yamashita T, Oka S. Initial experience of video-assisted thoracic surgery lobectomy with partial removal of the pulmonary artery. Interact Cardiovasc Thorac Surg. 2008;7:996–1000.CrossRefGoogle Scholar
  25. 25.
    Xu X, Huang J, Pan H, Chen H, He J. Video-assisted thoracoscopic bronchoplasty/pulmonary arterial angioplasty. J Thorac Dis. 2016;8(3):544–52.CrossRefGoogle Scholar
  26. 26.
    Gonzalez-Rivas D, Delgado M, Fieira E, Fernandez R. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg. 2014;3(2):E2.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Yang R, Shao F, Cao H, Liu Z. Bronchial anastomosis using complete continuous suture in video-assisted thoracic surgery sleeve lobectomy. J Thorac Dis. 2013;5:321–2.Google Scholar
  28. 28.
    Agasthian T. Initial experience with video-assisted thoracoscopic bronchoplasty. Eur J Cardiothorac Surg. 2013;44:616–23.CrossRefGoogle Scholar
  29. 29.
    Bagan P, Le Pimpec-Barthes F, Badia A, Crockett F, Dujon A, Riquet M. Bronchial sleeve resections: lung function resurrecting procedure. Eur J Cardiothorac Surg. 2008;34:484–7.CrossRefGoogle Scholar
  30. 30.
    Cerfolio RJ, Deschamps C, Allen MS, Trastek VF, Pairolero PC. Mainstem bronchial sleeve resection with pulmonary preservation. Ann Thorac Surg. 1996;61:1458–62.CrossRefGoogle Scholar
  31. 31.
    Bölükbas S, Schirren J. Parenchyma-sparing bronchial sleeve resections in trauma, benign and malign diseases. Thorac Cardiovasc Surg. 2010;58:32–7.CrossRefGoogle Scholar
  32. 32.
    Ragusa M, Vannucci J, Cagini L, Daddi N, Pecoriello R, Puma F. Left main bronchus resection and reconstruction: a single institution experience. J Cardiothorac Surg. 2012;7:29.CrossRefGoogle Scholar
  33. 33.
    Tang J, Cao M, Qian L, Fu Y, Tang J, Zhao X. The pure distal left main bronchial sleeve resection with total lung parenchymal preservation: report of two cases and literature review. J Thorac Dis. 2014;6:294–8.Google Scholar
  34. 34.
    Regnard JF, Fourquier P, Levasseur P. Results and prognostic factors in resections of primary tracheal tumors: a multicenter retrospective study. J Thorac Cardiovasc Surg. 1996;111:808–13.CrossRefGoogle Scholar
  35. 35.
    Maziak DE, Todd TR, Keshavjee SH, Winton TL, Van Nostrand P, Pearson FG. Adenoid cystic carcinoma of the airway: thirty-two-year experience. J Thorac Cardiovasc Surg. 1996;112:1522–31.CrossRefGoogle Scholar
  36. 36.
    Maeda M, Nakamoto K, Tsubota N, Okada T, Katsura H. Operative approaches for left-sided carinoplasty. Ann Thorac Surg. 1993;56:441–5.CrossRefGoogle Scholar
  37. 37.
    Porhanov VA, Poliakov IS, Selvaschuk AP, Grechishkin AI, Sitnik SD, Nikolaev IF, et al. Indications and results of sleeve carinal resection. Eur J Cardiothorac Surg. 2002;22:685–94.CrossRefGoogle Scholar
  38. 38.
    Shao F, Yang R, Xu D, Zou W, Ma G, Cao H, et al. Bronchial sleeve lobectomy and carinal resection in the treatment of central lung cancer: a report of 92 cases. Zhongguo Fei Ai Za Zhi. 2010;13:1056–8.PubMedGoogle Scholar
  39. 39.
    Weder W, Inci I. Carinal resection and sleeve pneumonectomy. Thorac Surg Clin. 2014;24:77–83.CrossRefGoogle Scholar
  40. 40.
    Watanabe Y, Murakami S, Iwa T, Murakami S. The clinical value of high-frequency jet ventilation in major airway reconstructive surgery. Scand J Thorac Cardiovasc Surg. 1988;22:227–33.CrossRefGoogle Scholar
  41. 41.
    Ng CS, Rocco G, Wong RH, Lau RW, Yu SC, Yim AP. Uniportal and single-incision video-assisted thoracic surgery: the state of the art. Interact Cardiovasc Thorac Surg. 2014;19:661–6.CrossRefGoogle Scholar
  42. 42.
    Rocco G. One-port (uniportal) video-assisted thoracic surgical resections-A clear advance. J Thorac Cardiovasc Surg. 2012;144:27–31.CrossRefGoogle Scholar
  43. 43.
    Ng CS, Lau KK, González-Rivas D, Rocco G. Evolution in surgical approach and techniques for lung cancer. Thorax. 2013;68:681.CrossRefGoogle Scholar
  44. 44.
    Petersen R, Hansen H. Learning thoracoscopic lobectomy. Eur J Cardiothorac Surg. 2010;37:516–52.CrossRefGoogle Scholar
  45. 45.
    Gonzalez-Rivas D, Yang Y, Sekhniaidze D, Stupnik T, Fernandez R, Lei J, Zhu Y, Jiang G. Uniportal video-assisted thoracoscopic bronchoplastic and carinal sleeve procedures. J Thorac Dis. 2016;8(Suppl 2):S210–22.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Rendina E, De Giacomo T, Venuta F, Ciccone A, Coloni G. Lung conservation techniques: bronchial sleeve resection and reconstruction of the pulmonary artery. Semin Surg Oncol. 2000;18:165–72.CrossRefGoogle Scholar
  47. 47.
    Burfeind WR Jr, D’Amico TA, Toloza EM, Wolfe WG, Harpole DH. Low morbidity and mortality for bronchoplastic procedures with and without induction therapy. Ann Thorac Surg. 2005;80:418–21.CrossRefGoogle Scholar
  48. 48.
    Santambrogio L, Cioffi U, De Simone M, Rosso L, Ferrero S, Giunta A. Video-assisted sleeve lobectomy for mucoepidermoid carcinoma of the left lower lobar bronchus: a case report. Chest. 2002;121:635–6.CrossRefGoogle Scholar
  49. 49.
    Nakanishi R, Fujino Y, Yamashita T, Shinohara S, Oyama T. Thoracoscopic anatomic pulmonary resection for locally advanced non-small cell lung cancer. Ann Thorac Surg. 2014;97:980–6.CrossRefGoogle Scholar
  50. 50.
    Shao WL, Liu LX, He JX, Yang YY, Chen HZ, Wu ZF, et al. Bronchial sleeve resection and reconstruction of pulmonary artery by video-assisted thoracic small incision surgery for central lung cancer: a report of 139 cases. Zhonghua Wai Ke Za Zhi. 2007;45:1530–2.PubMedGoogle Scholar
  51. 51.
    Gonzalez D, De la Torre M, Paradela M, Fernandez R, Delgado M, Garcia J, et al. Video-assisted thoracic surgery lobectomy: 3-year initial experience with 200 cases. Eur J Cardiothorac Surg. 2011;40:e21–8.CrossRefGoogle Scholar
  52. 52.
    Mahtabifard A, Fuller CB, McKenna RJ Jr. Video-assisted thoracic surgery sleeve lobectomy: a case series. Ann Thorac Surg. 2008;85:729–32.CrossRefGoogle Scholar
  53. 53.
    Li Y, Wang J. Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty: an improved operative technique. Eur J Cardiothorac Surg. 2013;44:1108–12.CrossRefGoogle Scholar
  54. 54.
    Gonzalez-Rivas D, Marin JC, Granados JP, Llano JD, Cañas SR, Arqueta AO, de la Torre M. Uniportal video-assisted thoracoscopic right upper sleeve lobectomy and tracheoplasty in a 10-year-old patient. J Thorac Dis. 2016;8(9):E966–9. Scholar
  55. 55.
    Tsuchiya R. Bronchoplastic techniques. In: Pearson FG, Cooper JD, Deslauriers J, editors. Thoracic surgery. 2nd ed. Philadelphia: Churchill Livingstone; 2002. p. 1005–13.Google Scholar
  56. 56.
    Kara HV, Balderson SS, D’Amico TA. Challenging cases: thoracoscopic lobectomy with chest wall resection and sleeve lobectomy-Duke experience. J Thorac Dis. 2014;6:637–40.Google Scholar
  57. 57.
    Gonzalez-rivas D, Fieira E, Delgado M, Mendez L, Fernandez R, De la Torre M. Uniportal video-assisted thoracoscopic lobectomy. J Thorac Dis. 2013;5:234–45.Google Scholar
  58. 58.
    Gonzalez-Rivas D, Yang Y, Stupnik T, Sekhniaidze D, Fernandez R, Velasco C, Zhu Y, Giang G. Uniportal video-assisted thoracoscopic bronchovascular, tracheal and carinal resections. Eur J Cardiothorac Surg. 2015;49:i6–i16. Scholar
  59. 59.
    Li X, Pan X, Zhang C, Zhu D, Zhao J. Video-assisted thoracoscopic sleeve lobectomy. J Thorac Dis. 2014;6:1351–3.PubMedPubMedCentralGoogle Scholar
  60. 60.
    Liu K, Jin C, Tian H, Shen W. Total video-assisted thoracic surgery sleeve lobectomy: suture by both hands. Thorac Cardiovasc Surg Rep. 2013;2:43–5.CrossRefGoogle Scholar
  61. 61.
    Lu H, Zhang Z, Li W, Hu D. Video-assisted thoracic surgery right sleeve lobectomy. J Thorac Dis. 2013;5:323–4.Google Scholar
  62. 62.
    Jiao W, Zhao Y, Huang T, Shen Y. Two-port approach for fully thoracoscopic right upper lobe sleeve lobectomy. J Cardiothorac Surg. 2013;8:99.CrossRefGoogle Scholar
  63. 63.
    Han Y, Zhou S, Yu D, Song X, Liu Z. Video-assisted thoracic surgery (VATS) left upper sleeve lobectomy with partial pulmonary artery resection. J Thorac Dis. 2013;5:301–3.Google Scholar
  64. 64.
    Liu L, Mei J, Pu Q, Ma L. Thoracoscopic bronchovascular double sleeve lobectomy for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;46:493–5.CrossRefGoogle Scholar
  65. 65.
    Peng G, Cui F, Ang KL, Zhang X, Yin W, Shao W, Dong Q, Liang L, He J. Non-intubated combined with video-assisted thoracoscopic in carinal reconstruction. J Thorac Dis. 2016;8(3):586–93. Scholar
  66. 66.
    Li J, Wang W, Jiang L, Yin W, Liu J, Shao W, Chen H, Ang KL, Jiao W, Kang M, He J. Video-assisted thoracic surgery resection and reconstruction of carina and trachea for malignant or benign disease in 12 patients: three centers’ experience in China. Ann Thorac Surg. 2016;102(1):295–303.CrossRefGoogle Scholar
  67. 67.
    Huang J, Li J, Qiu Y, Xu X, Sekhniaidze D, Chen H, et al. Thoracoscopic double sleeve lobectomy in 13 patients: a series report from multi-centers. J Thorac Dis. 2015;7:834–42.PubMedPubMedCentralGoogle Scholar
  68. 68.
    Lyscov A, Obukhova T, Ryabova V, Sekhniaidze D, Zuiev V, Gonzalez-Rivas D. Double-sleeve and carinal resections using the uniportal VATS technique: a single centre experience. J Thorac Dis. 2016;8(Suppl 3):S235–41.PubMedPubMedCentralGoogle Scholar
  69. 69.
    Jiang L, Liu J, Gonzalez-Rivas D, Shargall Y, Kolb M, Shao W, Dong Q, Liang L, He J. Thoracoscopic surgery for tracheal and carinal resection and reconstruction under spontaneous ventilation. J Thorac Cardiovasc Surg. 2018;155(6):2746–54.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Diego Gonzalez-Rivas
    • 1
    • 2
    Email author
  • Jiang Lei
    • 3
  • Dmitrii Sekhniaidze
    • 4
  1. 1.Department of Thoracic Surgery, Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina
  2. 2.Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI)Coruña University HospitalCoruñaSpain
  3. 3.Department of Thoracic Surgery, Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina
  4. 4.Department of Thoracic SurgeryRegional Oncological CenterTyumenRussian Federation

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