Objectives: Clinical research in recent years has shown expanding indications for surgical stabilization of rib fractures (SSRF). Multiple studies have shown improvements in outcomes with implementation of VATS for evacuation of traumatic retained hemothoraces, identification of injuries and decreased time until chest tube removal. A variety of techniques may be employed. The technique we describe utilizes a uniportal method and we have selection criteria for single lumen intubation and intermittent apnea to facilitate visualization, alleviating the need for a dual lumen endotracheal tube. The use of a uniportal VATS is not novel, but is likely under-discussed especially in the trauma literature despite the fact that it is of large value and can be performed by trauma surgeons with limited resources. Our Level 1 trauma facility has successfully implemented a standard of uniportal VATS in conjunction with SSRF as well as an independent operation for isolated retained hemothoraces. A majority of patients are managed safely with single lube intubation and intermittent apnea, but we occasionally use dual lumen intubation when deemed necessary. We describe our technique that is quick, easy and widely applicable at trauma institutions who have basic surgical capabilities.
