Video-assisted thoracoscopic surgery (VATS) segmentectomy

The safety and feasibility of the video-assisted thoracoscopic surgery (VATS) approach to segmentectomy have been widely demonstrating, although the rule of anatomical sublobar resection as a definitive management of early-stage non-small cell lung cancer is still controversial. To date, thoracoscopic segmentectomy is principally indicated in elevated risk patient that cannot tolerate standard lobectomy. The different surgical technique has been described and a growing number of dedicated instrumentation and technology to safely perform anatomical segmentectomy are available. Compared to standard VATS lobectomy, segmentectomy is a more challenging procedure, and surgeon experience is critical. VATS segmentectomy should be considered as a valid option for the management of patients with small-sized early stage NSCLC, not larger than 2 cm. The only absolute contraindication to segmentectomy is the inability to obtain radical resection.