Surgical technique: lung-sparing sleeve bronchoplasty

: Total lung-parenchyma-sparing bronchoplasty is a step forward in the treatment of low-grade malignant tumors and benign endobronchial lesions because it allows resection while preserving lung capacity. This technique is feasible in several of the bronchial segments, including the right main bronchus, the intermedius bronchus, and the left main bronchus. Conventionally bronchoplasty has been done using open surgery with a thoracotomy, but lung-parenchyma-sparing bronchoplasty can now be performed minimally invasively by experienced surgeons through a single incision, resulting in less pain, fewer complications, a faster recovery, and equivalent oncological results. Low-grade, localized tumors and benign strictures are the ideal pathologies for lung-sparing bronchoplasty. Keys factors for optimal results include proper patient selection, a thorough oncological and functional evaluation, and meticulous surgical technique to attain negative margins and a complete resection. Reports on uniportal lung-parenchyma-sparing bronchoplasty, although scarce due to the nature and complexity of the procedure, have been published confirming the feasibility and safety of the procedure when performed by well-trained surgeons. Here, we present a lung-parenchyma-sparing sleeve resection and anastomosis using a uniportal approach through a single 3–4 cm incision in the 5th intercostal space to treat a typical carcinoid tumor (a low-grade neuroendocrine tumor) in the left main bronchus.