Full thoracoscopic fissure based technique for major pulmonary resections: rational and basic considerations

We report the basics and rational of the technique for major pulmonary resections (MPR) that has been used in 1,050 patients. (I) Full thoracoscopic technique without access incision but with the number of ports that is necessary for optimal exposure. To minimize chest wall trauma and torquing, we use a deflectable scope and the diameter of instruments is reduced to 5 mm or even 3 mm. Their ergonomics and features are adapted to the specific requirements of thoracoscopic surgery. (II) Fissure based approach in order to achieve optimal vascular and lymph node dissection.