Doosang Kim, Young-Mee Ahn, Yong-Ho Rho.
Seoul Veterans Hospital, Seoul, Republic of Korea.
OBJECTIVE: Latissimus dorsi and serratus anterior muscle-sparing vertical thoracotomy is appeared as an good alternative of standard posterolateral thoracotomy, because it does not need rib cutting or fracture and muscle dissection, therefore it leads to good cosmesis, less postoperative pain and well-preserved shoulder motion. However, it also needs skin incision about more than 4 inches to make a hand in. We modified Videoscope-assisted latisimus dorsi and serratus anterior Muscle-sparing Vertical Thoracotomy (VMVT) as a new method and reduced skin incision to about 2 inches to make instruments only in.
METHODS: We performed muscle-sparing vertical thoracotomy without dissecting lattissimus dorsi and serratus anterior muscles in 393 cases from October 2000 to December 2007. Among them, there are 18 cases of Videoscope-assisted Muscle-sparing Vertical Thoracotomy for lung cancer surgery.
RESULTS: Their mean age is 69 ± 9 years old (range 46-83) and 16 male and two female patients. Operative procedures were lobectomy in 13 cases, limited resection including wedge in 3, pneumonectomy in one, and lobectomy and diaphragm resection in one. Mean operation time is 134 ± 56 min (range 65-270). There are no operative morbidities and mortalities. They had no rib fractures or cuttings and no seroma formations.
CONCLUSIONS: We concluded that videoscope-assisted muscle-sparing vertical thoracotomy is a safe and feasible method in lung cancer surgery. 
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