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Abu Akar et al. Mini-invasive Surg 2020;4:10 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.65

Technical Note Open Access

Subxiphoid uniportal video assisted thoracoscopic
lobectomy in a pediatric patient

Firas Abu Akar , Bisanne Shaqqura , Nisreen Rumman , Lei Jiang
1
1
2
3
1 Department of Cardiothoracic surgery, Makassed Charitable Society Hospital, East Jerusalem 97103, Palestine.
2 Department of pediatrics, Makassed Charitable Society Hospital, East Jerusalem 97103, Palestine.
3 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433,
China.
Correspondence to: Dr. Firas Abu Akar, Department of Cardiothoracic Surgery, Al-Makassed Charitable Society Hospital,
East Jerusalem, Affiliated to Al-Quds University School of Medicine, Jerusalem 97103, Palestine. E-mail: firasabuakar@gmail.com

How to cite this article: Abu Akar F, Shaqqura B, Rumman N, Jiang L. Subxiphoid uniportal video assisted thoracoscopic
lobectomy in a pediatric patient. Mini-invasive Surg 2020;4:10. http://dx.doi.org/10.20517/2574-1225.2019.65
Received: 25 Dec 2019 First Decision: 16 Jan 2020 Revised: 17 Jan 2020 Accepted: 3 Feb 2020 Published: 14 Feb 2020

Science Editor: Noriyoshi Sawabata Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Thoracoscopic surgeries have witnessed tremendous and prompt recent development, especially in the field of uniportal
video assisted thoracoscopic surgery (VATS) surgery. It is now possible to perform the most complex surgeries through
this technique, which is of great benefit to the patient by significantly reducing the level of postoperative pain and
complications of surgery. As surgeons gain experience in this field, their confidence and ability to push the limits and
develop technologies are increasing. Performing uniportal VATS surgeries in children is a significant challenge for the
surgeon due to the limited size of the thoracic cavity and the difficulty of the instrumentation. Here, we report the first
case in the literature (as far as we know) of a uniportal Subxiphoid VATS lobectomy in a 2.5-year-old child. In conclusion,
Subxiphoid uniportal VATS lobectomy is feasible in pediatric patients and may have some benefits over the intercostal
approach.

Keywords: Subxiphoid uniportal video assisted thoracoscopic surgery in pediatrics, minimally invasive thoracic surgery
in children, VATS lobectomy in pediatrics, pediatric thoracic surgery

INTRODUCTION
Despite the significant development of adult thoracoscopic surgery in the last two decades, especially the
uniportal video assisted thoracoscopic surgery (VATS) technique, which may be performed through the
intercostal, subxiphoid, or subcostal approach, the utilization of the uniportal technique in children is still

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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