Posterior uniportal video-assisted thoracoscopic surgery for resection of the apical segment of the right lower lobe followed by completion lobectomy.

Uniportal thoracoscopic resections offer less pain and better cosmetic results. They are usually performed through an antero-lateral incision. Posterior uniportal approach has not been described yet. A 65-year-old female was admitted to our clinic for the treatment of an adenocarcinoma, located in the apical segment of the right lower lobe. Owing to the ideal location and size, anatomical segment resection and radical lymphadenectomy was planned. Fissureless video-assisted thoracoscopic resection of the apical segment of the right lower lobe, using a uniportal posterior approach was performed, followed by mediastinal lymphadenectomy. However, resection margins showed microscopic presence of lepidic tumour on frozen section analysis, so we needed to proceed with a completion lower lobectomy. Postoperative course was event-free and the patient was discharged on the 4th postoperative day. The 1.8-cm large tumour was diagnosed to be primary lepidic (80%) and acinar (20%) adenocarcinoma and the final TNM was pT2aN0M0.