Uniportal VATS pneumonectomy right

Incision of approximately 4 cm in length in the area of the anterior axillary line at the upper edge of the 5th rib to access the 4th intercostal space above. A helpful orientation is often an imaginary line from the tip of the scapula to the nipple. Transection of the subcutaneous tissue on the rib with the monopolar knife. Subsequently, stepwise preparation of the intercostal muscles with the monopolar knife. The pleura is opened bluntly with a finger. Palpation of the thoracic wall for adhesions and insertion of a wound protection film.

First, the lung is luxated dorsolaterally, providing a view of the azygos vein. This is then freed from the pleural covering using an electric hook, bluntly dissected circularly, secured with titanium clips, and sharply transected.

Note:

• The resection of the azygos vein can be performed using clips, hand sutures, or a stapling device. Its transection facilitates the subsequent dissection and closure of the right main bronchus, although it is not mandatory.