Uni-portal thoracoscopic lymph node dissection under the left prominence: pause ventilation technique

Uni-portal video-assisted thoracoscopic lobectomy (UVATS) has become a well-established technique; however, performing a complete lymphadenectomy, particularly the removal of lymph nodes located below the left hemithorax (LHLN), remains a challenging procedure. To our knowledge, there are limited reports addressing the use of pause ventilation during UVATS for LHLN dissection. In this study, we propose the application of pause ventilation for facilitating LHLN dissection under UVATS. Through transnasal humidified rapid-insufflation ventilatory exchange (THRIVE), we innovatively implemented an intermittent apnea technique during surgery, enabling UVATS dissection of the LHLN. This study details the surgical procedure and includes an accompanying operative video.

The application of pause ventilation can promote LHLN dissection under UVATS.

The use of pause ventilation for LHLN dissection in UVATS appears safe and feasible, providing clear exposure of key surrounding tissues and organs.