The role of video-assisted thoracic surgery for carcinoma of the lung: wedge resection to lobectomy by simultaneous individual stapling.

Despite a plethora of technologic advances, there has been only minimal improvement in the surgical treatment of carcinoma of the lung during the past 15 years. The advent of video-assisted thoracic surgical (VATS) techniques, however, is opening up new vistas and providing unimagined options for more accurate diagnosis, more precise staging, and more specific resections of lung tumors. Currently, a voluminous surgical literature supports tissue conservation, in selected patients, for the curative resection of peripheral malignant nodules less than 2 cm in diameter. Because these lesions are very accessible to a VATS resection, such procedures can be satisfactorily performed to meet the individual needs of the patient (ie, wedge, subsegmental, segmental, and sublobar resections, as well as traditional or SIS-lobectomy [simultaneous individual stapling of hilar structures]). As the technology advances, members of other specialties are beginning to develop a keen interest in the treatment of carcinoma of the lung. If thoracic surgeons are to prevail in the treatment of carcinoma of the lung, for the benefit of their patients, they must remain vigilant, informed, and versatile in their approach to this disease. This involves learning, understanding, and incorporating these new technologic advances into their armamentarium.