Despite the expanding indications for video-assisted thoracic surgery, there have been few reports of chest wall resection and isolated rib resection, and in some cases specific instruments are needed . Recently, Nakagiri et al.  described thoracoscopic rib resection using a Gigli saw, which is widely used for the resection of other bones. Rocco et al.  also a Gigli saw for rib resection, and further performed reconstruction with a titanium plate to prevent lung herniation. In their reports, however, multiple ports were used. Although reports of thoracoscopic surgery performed with single incision are increasing , single-port thoracoscopic rib resection has not been reported.
As described in Rocco’s studies and reviews [1, 5], single-port thoracoscopic surgical resections can decrease postoperative pain and hospital stay when compared with conventional 3-port procedures. We perform single-port thoracoscopic rib resection successfully. In our patient, the target area for rib resection was located at the posterior paraspinal region. The port was designed for using the Gigli saw in a perpendicular direction, which allowed the target rib to be most effectively resected. If the target rib is located in a lateral or anterior aspect, grasping instruments could be used to change the direction of the Gigli saw. Thoracoscopes with smaller diameter (5 mm or 3 mm) may offer more space for instruments manipulation or decreased the size of wound in this single-port method. But higher technology may be required to avoid compromising the brightness and resolution.