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Sathiamurthy et al . Mini-invasive Surg 2020;4:38 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.25

Technical Note Open Access

Early experience of uniportal video assisted
thoracoscopic surgery in a New Thoracic Unit in
Hospital Kuala Lumpur, Malaysia

Narasimman Sathiamurthy , Nguk Chai Diong , Benedict Dharmaraj
2
1
2
1 Consultant Thoracic & General Surgeon, Thoracic Unit, Hospital Kuala Lumpur, Kuala Lumpur 505860, Malaysia.
2 Thoracic Fellow, Hospital Kuala Lumpur, Thoracic Unit, Hospital Kuala Lumpur, Kuala Lumpur 505860, Malaysia.
Correspondence to: Dr Narasimman Sathiamurthy, Consultant Thoracic & General Surgeon, Thoracic Unit, Hospital Kuala
Lumpur, Kuala Lumpur 505860, Malaysia. E-mail: drnara@hotmail.com

How to cite this article: Sathiamurthy N, Diong NC, Dharmaraj B. Early experience of uniportal video assisted thoracoscopic
surgery in a New Thoracic Unit in Hospital Kuala Lumpur, Malaysia. Mini-invasive Surg 2020;4:38.
http://dx.doi.org/10.20517/2574-1225.2020.25

Received: 21 Feb 2020 First Decision: 4 Mar 2020 Revised: 30 Mar 2020 Accepted: 12 May 2020 Published: 18 Jun 2020

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

Abstract
The evolution of video technology and instrumentation have revolutionised the way lung resections are performed
without compromising outcomes. In a new thoracic surgery setup, we have adopted the uniportal video assisted
thoracoscopic surgery (U-VATS) technique for lung resections in most of our cases. A retrospective review of
operative records from July 2017 till June 2019 in Hospital Kuala Lumpur (HKL) for all thoracic surgeries was done.
Patients were divided into two groups: those that underwent U-VATS surgery in the first and second year as part
of the learning curve. The operative time, blood loss, lymph node yield, duration of drain placement, and length of
hospital stay were compared between the groups. The most common indication for U-VATS surgery was malignant
lung tumors (21%) followed by ruptured bullae (20%) and empyema thoracis (15%). The average time taken for
lobectomies performed for non-small cell lung cancer was 201 min. U-VATS decortication caused the most amount
of blood loss with an average of 350 mL, followed by aspergilloma at 315 mL and bronchoplasty at 250 mL. The
rest of the procedures had < 150 mL of blood loss. There was no significant difference in the parameters compared
between procedures in the two groups.No mortality was seen.The learning curve of U-VATS was used as a guide
to gradually increase the complexity of cases performed in a pyramidal manner. U-VATS is an alternative and
promising minimal access approach in thoracic surgery that can be safely performed in Malaysia.

Keywords: Uniportal, video assisted thoracoscopic surgery, Hospital Kuala Lumpur, early experience

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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