Extended pleurectomy and decortication: Video atlas of operative steps

Abstract

Video clip is available online.Feature Editor Note-Video Atlas Articles (VAAs) are peer-reviewed descriptions of an operative procedure distilled into a series of steps, with each step taught to the reader through its own narrated video and short corresponding text. The purpose of the VAA is to provide continuing surgical education in a format that is qualityassured, easily accessible, and high impact. Much of the excitement around our new series of VAAs surrounds robotic and thoracoscopic/laparoscopic procedures. Our field has progressed rapidly into one in which robotic and thoracoscopic surgery have improved clinical outcomes, and we drive much of the innovation in minimally invasive surgical platforms and technique. The ability to record highresolution video during the routine conduct of robotic and thoracoscopic/laparoscopic surgery has facilitated this opportunity in structured, peer-reviewed, expert instruction of index cases in thoracic surgery and is the bedrock for the VAA initiative. Open surgery, however, has become less frequent in our training programs, and operations that are performed open are now more likely to be complex rather than routine cases. This highlights a gap in surgical training that can be narrowed with novel methods of continuing surgical education. In this VAA, the authors describe an extended pleurectomy/decortication procedure for malignant pleura mesothelioma in a structured and comprehensive series of 12 steps. High-resolutions videos recorded from a surgeon's headlight camera are provided for each step and allow the reader to experience the conduct of each step of this complex, open operation from the surgeon's perspective. This is the first VAA of an open procedure and showcases the potential of this format to advance continuing surgical education for open thoracic surgery.

Commentary: Extended pleurectomy decortication: Step 1, standardized techniques; step 2, standardized documentation

“…The authors have taken all the pearls not only from their own substantial experience but also from the literature to provide both EPD veterans and rising mesothelioma surgeons with a mental checklist to be crossed off during the procedure. 3 This is a must read for every mesothelioma surgical expert across the globe, whether he or she performs 5 procedures per year or 50 per year.…”