Uniportal thoracoscopic upper division segmentectomy of left upper lobe using a unidirectional anterior approach.

Thoracoscopic major pulmonary resection via a uniportal approach is becoming more common worldwide as the adoption of minimally invasive surgical procedures increases. With a uniportal approach, 3 or 4 surgical instruments, including a thoracoscope, are simultaneously inserted via an approximately 4-cm access port. The surgeon must master the surgical techniques required to perform a major pulmonary resection safely using the uniportal method, specifically the challenge of dissecting the tissue and inserting staplers unidirectionally, due to the limited angle of approach.  In this video tutorial, we demonstrate a uniportal thoracoscopic upper division segmentectomy of the left upper lobe of a patient with primary lung cancer, using a unidirectional anterior approach without dissection of the fissure. We explain the nuances of the procedure and how to perform it, and we discuss our successful results.