En bloc lymphadenectomy of the right thorax via a uniportal thoracoscopic approach.

The uniportal approach to an en bloc complete lymphadenectomy is significantly more challenging than a multiportal approach or a thoracotomy because of the limited angulation available to the surgeon and the limited number of usable surgical instruments. Because of these limitations, it is very important to completely master the specific surgical steps in order to achieve success. Additionally, it is important to make sure the lymph nodes remain structurally intact, taking care not to cause damage by grasping them during lymphadenectomy, in order to prevent the dissemination of malignant cells into the thorax. In this video tutorial, we demonstrate our surgical technique for lymphadenectomy in the right upper (2R/4R) or lower (7/8/9) mediastinal zone, which is suitable for a uniportal approach, and explain the nuances of performing it.