For bilateral multiple pulmonary nodules, two-stage surgery imposes a significant physical and psychological burden on patients due to repeated anesthesia and surgical trauma, making one-stage bilateral surgery a theoretically more ideal treatment strategy. However, conventional one-stage bilateral surgery via the intercostal approach often requires intraoperative repositioning, resulting in greater trauma and prolonged operative time, while the subxiphoid approach faces challenges including insufficient surgical field exposure and severely limited operative space, posing high surgical risks during anatomical lobectomy. This article reports a 54-year-old male patient with bilateral multiple pulmonary nodules, who required a simultaneous left upper lobe wedge resection and a right middle lobectomy. Accordingly, our team successfully performed subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for one-stage bilateral pulmonary resection. By innovatively incorporating the balance-shaped sternal elevation device for percutaneous suspension technique into subxiphoid uniportal VATS, the operative space was significantly expanded and surgical field exposure was markedly optimized, reducing the risk and difficulty of pulmonary resection via the subxiphoid approach. The patient recovered uneventfully, and short-term follow-up revealed no abnormalities.
