Clinical outcomes of unisurgeon video-assisted thoracoscopic lobectomy: A single-center retrospective study

<bold>Background:</bold> The "Unisurgeon" concept, introduced by Diego Gonzalez-Rivas in 2017, refers to video-assisted thoracoscopic surgery (VATS) lobectomy performed solely by a single surgeon, without an assistant handling the camera or lung retraction. While the feasibility of this approach has been proposed, real-world clinical outcomes remain underexplored. <bold>Objective:</bold> This study aims to evaluate the safety and clinical outcomes of "Unisurgeon VATS" lobectomy, focusing on operative efficiency, complication rates, and conversion to thoracotomy. <bold>Methods:</bold> A retrospective analysis was conducted on 50 patients who underwent single-surgeon VATS lobectomy between January 2024 and November 2024 at a single institution. Lower lobectomies were performed using two-port VATS, while upper lobectomies utilized three-port VATS. A camera holder was used in all procedures to enhance stability and visualization. Patient demographics, intraoperative events, and postoperative outcomes were reviewed. <bold>Results:</bold> The most common indication was lung cancer (n=23, 46%), and left upper lobectomy (n=15, 30%) was the most frequently performed procedure. Conversion to thoracotomy was required in 3 patients. Postoperative complications were recorded in 7 patients (14%). Postoperative mortality occurred in 2 patients (4%). <fig><object-id>erj;66/suppl_69/PA4853/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusion:</bold> Single-surgeon VATS lobectomy utilizing a camera holder is a feasible and safe technique for pulmonary resections.