Video-assisted thoracoscopic surgery (VATS) is though to be a
minimally invasive surgical procedure of lung resection. But there are some problems still remained about training, cost efficacy and oncological principles. Minimally invasive
thoracotomy without thoracoscopic procedure was reviewed in this paper. In case of standard posterolateral
thoracotomy with cutting ribs, it brings less
postoperative pain and less dislocation of the ribs that fixes the ribs with bioabsorbable
poly-L-lactide (PLLA) pins. Muscle sparing
thoracotomy is available in broadly peeling off the muscle of trapezius and latissimus dorsi subcutaneously. But sometime much exudate collects subcutaneous
wound in postoperative period so that some trouble or complication often occurs in the management of postoperative course. In case of axilloanterior
thoracotomy we have proper view which is almost the same as standard posterolateral
thoracotomy without cutting thoracic muscles. Skin incision runs from the axillar to the lateral margin of the breast and the 4th or 5th intercostal
thoracotomy is performed through thoracodorsal muscle being pressed laterally, anterior serratus muscle being split. There is no need to cut the ribs, and good for the upper or middle lobectomy and the upper mediastinal dissection. Axilloanterior
thoracotomy is minimally invasive than standard posterolateral
thoracotomy and is useful for the surgery of upper or middle lobe
lung cancer. In the procedure of
thoracotomy operating with or without
thoracoscope is not to be concerned. Important is to perform operation smoothly in adequate time for patients ease.