Uniportal thoracoscopic management of middle lobe torsion after upper lobectomy

[Troubleshooting Common Unexpected Situations during Thoracoscopic Anatomical Pulmonary Resection]

The history of modern thoracoscopic pulmonary surgery could date back to the 1990s, and the related surgical technique has been matured after 20 years' development. Meanwhile, large amount of clinical data has been collected. Minimally invasive thoracic surgery represented by the thoracoscopic approach has been universally accepted as the preferred choice for the surgical treatment of early-staged non-small cell lung cancer and pulmonary benign diseases, and for the diagnosis of pulmonary diseases. With the generalization of thoracoscopic anatomical pulmonary resection, some unexpected situations during clinical practice has been reported in literatures, with issues involving anatomical variation, pathological factors, and surgical techniques. However, the systemic summary of the unexpected situations during thoracoscopic anatomical pulmonary resection is lacking until now. The present review, therefore, aims to summarize accidental issues and troubleshooting these unexpected situations on the basis of our own clinical practice and literature reports.