Left lower sleeve lobectomy and systematic lymph node dissection by single-incision video-assisted thoracic surgery

Sleeve lobectomy achieves complete resection of the intratracheal tumor with parenchyma preservation, a standard treatment of central lung cancer in selected patients (1,2). Due to its complex procedure, video-assisted thoracic surgery (VATS) sleeve lobectomy was once considered a contraindication. However, thanks to the improvement of technique and equipment, it has now become a common approach for minimally invasive thoracic surgery (3). Generally, 3-4 ports are used, and it was not until 2013 that the single-incision VATS sleeve lobectomy was first finished by Gonzalez-Rivas et al. (4). Left lower lobectomy with sleeve bronchial resection is considered as one of the most complex thoracic surgical procedures (5). Description of left bronchial anastomosis by uniportal VATS approach is limited. Here we present a technical procedure for left lower lobectomy with a sleeve resection by single-incision VATS