Closed chest lobectomy with subxyphoid retraction.

An important disadvantage of the video-assisted thoracoscopic surgery (VATS) lobectomy technique remains the minithoracotomy for specimen removal resulting in some degree of traction on the ribs even without the usage of a rib retractor. We describe a new technique of VATS lobectomy in supine position consisting of complete lymph node dissection and subxyphoidal removal of the lobe(s) preventing any degree of rib traction.