{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:09:46Z","timestamp":1773382186479,"version":"3.50.1"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Uniportal video-assisted thoracoscopic surgery (uVATS) provides excellent postoperative outcomes but limits instrument triangulation, making vascular stapling particularly challenging. We developed a simple \u201cpulley technique\u201d using a loop ligature device to create gentle, multidirectional, and dynamically adjustable traction during pulmonary vessel division. This technique involves passing a vessel tape around the target vessel through a loop ligature device and externalizing the tape to allow controlled retraction. The system stabilizes the vessel, improves the angle for stapler insertion, and minimizes the risk of overstretching. Compared with conventional traction methods, the pulley mechanism reduces instrument collision and provides more predictable tension distribution. The technique was successfully applied in multiple lobectomies and segmentectomies without vascular injury or conversion. Its simplicity, reproducibility, and low cost make it a valuable adjunct for improving safety and efficiency in uVATS.<\/jats:p>","DOI":"10.1093\/icvts\/ivag063","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:43:34Z","timestamp":1771937014000},"source":"Crossref","is-referenced-by-count":0,"title":["A Pulley-Assisted Ligature Technique for Safe and Versatile Vascular Division During Uniportal Video-Assisted Thoracic Surgery"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-3639","authenticated-orcid":false,"given":"Taichiro","family":"Goto","sequence":"first","affiliation":[{"name":"Lung Cancer and Respiratory Disease Center, Yamanashi Prefecture Central Hospital , Yamanashi 400-8506,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Natori","sequence":"additional","affiliation":[{"name":"Lung Cancer and Respiratory Disease Center, Yamanashi Prefecture Central Hospital , Yamanashi 400-8506,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Lung Cancer and Respiratory Disease Center, Yamanashi Prefecture Central Hospital , Yamanashi 400-8506,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rumi","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Lung Cancer and Respiratory Disease Center, Yamanashi Prefecture Central Hospital , Yamanashi 400-8506,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Nakagomi","sequence":"additional","affiliation":[{"name":"Lung Cancer and Respiratory Disease Center, Yamanashi Prefecture Central Hospital , Yamanashi 400-8506,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,1]]},"reference":[{"key":"2026031219464878200_ivag063-B1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.athoracsur.2012.10.070","article-title":"Uniportal video-assisted thoracoscopic lobectomy: techniques and early results","volume":"95","author":"Gonzalez-Rivas","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2026031219464878200_ivag063-B2","first-page":"434","article-title":"Ten-year experience on 644 uniportal video-assisted thoracoscopic surgery lung resections","volume":"101","author":"Rocco","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2026031219464878200_ivag063-B3","first-page":"930","article-title":"Comparative analysis of uniportal versus multiportal thoracoscopic lobectomy for lung cancer: an international multi-institutional study","volume":"53","author":"Wu","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026031219464878200_ivag063-B4","first-page":"456","article-title":"Simplified vessel retraction techniques during thoracoscopic pulmonary resection","volume":"21","author":"Shiono","year":"2015","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"2026031219464878200_ivag063-B5","first-page":"28","article-title":"Tips and pitfalls for vascular stapling in uniportal video-assisted thoracoscopic surgery","volume":"4","author":"Kim","year":"2018","journal-title":"J Vis Surg"},{"key":"2026031219464878200_ivag063-B6","first-page":"711","article-title":"Thoracic minimally invasive surgery\u2014current status and future directions","volume":"18","author":"Ng","year":"2021","journal-title":"Nat Rev Clin Oncol"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag063\/67188368\/ivag063.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/3\/ivag063\/67188368\/ivag063.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/3\/ivag063\/67188368\/ivag063.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T23:46:55Z","timestamp":1773359215000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivag063\/8502576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,1]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,12]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag063","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3,1]]},"article-number":"ivag063"}}