Learning curve and outcomes of young surgeons in uniportal video-assisted thoracoscopic surgery lobectomy using bent-tip thoracoscopic forceps for lung cancer.

Background: Uniportal video-assisted thoracoscopic surgery (VATS) is gaining popularity but may pose technical challenges for young surgeons in maintaining surgical precision compared to conventional multiportal VATS. This study assessed perioperative outcomes and lymph node dissection between uniportal VATS lobectomy using bent-tip thoracoscopic forceps to keep surgical precision and conventional multiportal VATS lobectomy for lung carcinoma. Methods: We retrospectively analyzed 215 consecutive patients who underwent multiportal or uniportal VATS lobectomy between January 2017 and December 2023, performed by surgeons in their 5th to 10th post-graduation years. Results: Among 95 uniportal and 120 multiportal cases, uniportal VATS showed significantly reduced operative time and blood loss. Propensity score matching was used to adjust for patient characteristic differences. Post-matching analysis revealed no significant differences in the number of lymph nodes dissected, mediastinal lymph node retrieval, or postoperative complications, while operative time and blood loss remained lower in the uniportal group. Three young surgeons with 7 years of postgraduate experience successfully trained in uniportal VATS, with cumulative sum plots indicating learning curve transition points between 7 and 14 cases. Conclusions: Uniportal VATS lobectomy for lung carcinoma can be performed safely and effectively by young surgeons, demonstrating its feasibility as a training approach.