Ergonomical Assessment of Three-Dimensional Versus Two-Dimensional Thoracoscopic Lobectomy

Elkhouly, Ahmed; Sorge, Roberto; Rogliani, Paola; Cristino, Benedetto; Wahby, Ehab; Serag, Amro R.; Liang, Hengrui; He, Jianxing; Pompeo, Eugenio

doi:10.1053/j.semtcvs.2020.05.018

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…Each investigator was blinded to the scoring data retrieved from the other surgeon. A previously used scoring system (3 = excellent, 2 = satisfactory and 1 = unsatisfactory) was adapted for complete thymectomy in the assessment of three ergonomic domains: maneuvering, exposure and instrumentation, as summarized in Table 1 [12]. Evaluation and scoring of each ergonomic domain were applied to four standardized surgical steps: dissection of lower thymic horns, upper thymic horns, innominate vein and perithymic fat.…”

Section: Scoring Systemmentioning

confidence: 99%

“…In order to better address the differences between robotic and thoracoscopic thymectomy, we retrospectively compared these two minimally invasive techniques under an ergonomic perspective. We adapted a previously developed ergonomic scoring system based on intraoperative impartial findings that are easily recognizable and quantifiable [12]. In addition, the relationship between ergonomic-based scores and operative time, as well as perioperative endpoints, was tested.…”

Section: Introductionmentioning

confidence: 99%

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Ergonomic Assessment of Robotic versus Thoracoscopic Thymectomy

Taje,

Peer,

Gallina

et al. 2024

JCM

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Introduction: Robotic and thoracoscopic surgery are being increasingly adopted as minimally invasive alternatives to open sternotomy for complete thymectomy. The superior maneuverability range and three-dimensional magnified vision are potential ergonomical advantages of robotic surgery. To compare the ergonomic characteristics of robotic versus thoracoscopic thymectomy, a previously developed scoring system based on impartial findings was employed. The relationship between ergonomic scores and perioperative endpoints was also analyzed. Methods: Perioperative data of patients undergoing robotic or thoracoscopic complete thymectomy between January 2014 and December 2022 at three institutions were retrospectively retrieved. Surgical procedures were divided into four standardized surgical steps: lower-horns, upper-horns, thymic veins and peri-thymic fat dissection. Three ergonomic domains including maneuverability, exposure and instrumentation were scored as excellent(score-3), satisfactory(score-2) and unsatisfactory(score-1) by three independent reviewers. Propensity score matching (2:1) was performed, including anterior mediastinal tumors only. The primary endpoint was the total maneuverability score. Secondary endpoints included the other ergonomic domain scores, intraoperative adverse events, conversion to sternotomy, operative time, post-operative complications and residual disease. Results: A total of 68 robotic and 34 thoracoscopic thymectomies were included after propensity score matching. The robotic group had a higher total maneuverability score (p = 0.039), particularly in the peri-thymic fat dissection (p = 0.003) and peri-thymic fat exposure score (p = 0.027). Moreover, the robotic group had lower intraoperative adverse events (p = 0.02). No differences were found in residual disease. Conclusions: Robotic thymectomy has shown better ergonomic maneuverability compared to thoracoscopy, leading to fewer intraoperative adverse events and comparable early oncological results.

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Section: Scoring Systemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ergonomic Assessment of Robotic versus Thoracoscopic Thymectomy

Taje,

Peer,

Gallina

et al. 2024

JCM

Self Cite

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“…Thoracoscopic lobectomy is associated with lower postoperative mortality and morbidity (33)(34)(35)(36). Based on its favorable profile on postoperative recovery and morbidity, VATS is now considered as the standard of care for patients with earlystage resectable NSCLC (37,38). RATS is not available in Egypt but out of 35 centers performing thoracic surgery, only four centers would perform routine thoracoscopic lobectomy for early-stage NSCLC.…”

Section: Lung Cancer Surgery In Egyptmentioning

confidence: 99%

Thoracic surgery in Egypt

Elkhayat¹,

Elsayed²,

Adel³

et al. 2022

J Thorac Dis

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A discrete‐event simulation model for assessing operating room efficiency of thoracic, gastrointestinal, and orthopedic surgeries

Pu,

Wu,

Han

2024

World j. surg.

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BackgroundIn hospital management, pinpointing steps that most enhance operating room (OR) throughput is challenging. While prior literature has utilized discrete event simulation (DES) to study specific strategies such as scheduling and resource allocation, our study examines an earlier planning phase, assessing all workflow stages to determine the most impactful steps for subsequent strategy development.MethodsDES models real‐world systems by simulating sequential events. We constructed a DES model for thoracic, gastrointestinal, and orthopedic surgeries summarized from a tertiary Chinese hospital. The model covers preoperative preparations, OR occupation, and OR preparation. Parameters were sourced from patient data and staff experience. Model outcome is OR throughput. Post‐validation, scenario analyses were conducted for each department, including: (1) improving preoperative patient preparation time; (2) increasing PACU beds; (3) improving OR preparation time; (4) use of new equipment to reduce the operative time of a selected surgery type; three levels of improvement (slight, moderate, large) were investigated.ResultsThe first three improvement scenarios resulted in a 1%–5% increase in OR throughput across the three departments. Large reductions in operative time of the selected surgery types led to approximately 12%, 33%, and 38% increases in gastrointestinal, thoracic, and orthopedic surgery throughput, respectively. Moderate reductions resulted in 6%–17% increases in throughput and slight reductions of 1%–7%.ConclusionsThe model could reliably reflect OR workflows of the three departments. Among the options investigated, model simulations suggest that improving OR preparation time and operative time are the most effective.

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Ergonomical Assessment of Three-Dimensional Versus Two-Dimensional Thoracoscopic Lobectomy

Cited by 6 publications

References 23 publications

Ergonomic Assessment of Robotic versus Thoracoscopic Thymectomy

Ergonomic Assessment of Robotic versus Thoracoscopic Thymectomy

Thoracic surgery in Egypt

A discrete‐event simulation model for assessing operating room efficiency of thoracic, gastrointestinal, and orthopedic surgeries

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