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Background: Carina resection and reconstruction is a challenging procedure for thoracic surgeons. We describe a novel technique of thoracoscopic carina reconstruction using the natural bifurcation, following pulmonary resection of the lung neoplasm. To our knowledge, it is the first report of this kind. Case presentation: A 71-year-old male diagnosed of squamous cell lung cancer received two-port approached video-assisted thoracoscopic right bilobectomy with carina resection after 2 cycles of neoadjuvant therapy. After the removal of right lower lobe and middle lobe, the 7 station lymph nodes were resected with the invaded carina and bronchial walls in an en-bloc fashion. The neocarina was reconstructed by the natural bifurcation between the right upper bronchus and the bronchus intermedius. Intraoperative blood loss was about 220 mL, and operative time was about 225 min. The postoperative course was uneventful. The pathological TNM stage was pT3N2M0, IIIA. Adjuvant chemotherapy using gemcitabine and cisplatin was administered for 4 cycles. Follow-up 6 months after surgery confirmed no stenosis and no signs of local recurrence by bronchoscopy and CT scan. Conclusions: We consider that the surgical procedure described here is a new alternative strategy for carina resection and reconstruction in the similar situation. The minimally invasive method is safe and effective for this challenging operation. [ABSTRACT FROM AUTHOR]

Background: Despite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system.Case Presentation: A case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful.Conclusions: Robotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience. [ABSTRACT FROM AUTHOR]

This report describes a case report of a minimally invasive technique for VATS right upper sleeve lobectomy with a two-port approach. To our knowledge it is the first report of this kind. A 50-year-old man with a pulmonary nodule occluding the orifice of the right upper lobe bronchus was referred to our department. Dissection, stapling the right upper lobe pulmonary vessels and anastomosis between the right intermediate and the right main bronchus were performed via the two port. To deal with blocking of pulmonary artery and obtain a satisfactory exposure and manipulating space in the course of bronchial anastomosis were the key points. Intraoperative blood loss was 150 ml and total operative time was 220 minutes. The postoperative course was uneventful. Chest X-rays showed no sign of atelectasis. Postoperative histopathological examination revealed that the tumor was T3N0M0 squamous cell carcinoma. The patient was discharged from hospital on postoperative day 9 without any complications. We conclude that video-assisted thoracoscopic sleeve lobectomy with mediastinal dissection by two-port approach is feasible and convenient. [ABSTRACT FROM AUTHOR]