Thoracoscopic Mediastinal Lymph Node Dissection Using an Endoscopic Spacer

Akiba, Tadashi; Marushima, Hideki; Hirai, Kyoji; Morikawa, Toshiaki

doi:10.5761/atcs.nm.11.01729

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…Many types of energy devices are available today and can make easier the lymph node dissection, although it's recommended to use them with care to avoid heat injury to vascular and nerve structures; it's undisputed however their usefulness to prevent bleeding that can obscure the field, slowing the dissection process due to poor viewing of the structures (15). Regarding mediastinal lymph node dissection, in some cases to improve the display of subcarinal and paraesophageal node stations it can be useful to retract the main bronchus anteriorly with a sponge stick and change the operating table orientation (15,16). In the presence of hilar lymphadenopathy closely adherent to the pulmonary artery branches, it's advisable to perform careful dissection maneuvers and plan for a method of pulmonary artery proximal control via VATS or via conversion to thoracotomy.…”

Section: Techniquesmentioning

confidence: 99%

Lymphadenectomy during thoracoscopy: techniques and efficacy

Curcio

Amore

2017

J. Vis. Surg.

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Nowadays several studies have shown that, in the management of patients with early-stage lung cancer, video-assisted thoracoscopic surgery (VATS) lobectomy compared to open surgery is associated with many clinical short-term benefits, such as less post-operative pain and shorter hospital stay. Despite the advantages described earlier, some authors have expressed concern about the effectiveness of the procedure arguing that the lymph node harvest performed during VATS lobectomy is inferior to that performed through thoracotomy access. Experience from a multicentre database, with a more balanced number of VATS versus open patients, actually has shown that there is no difference in the efficacy of mediastinal lymph node dissection during lobectomy for lung cancer by thoracoscopy and thoracotomy. In expert hands the technique of VATS lymphadenectomy is the same as that performed by thoracotomy: instrumentation and tricks can change but not the oncologic principles. We believe that is necessary to follow a learning curve not only for VATS lobectomy but also for thoracoscopic lymph node dissection. However even experienced VATS surgeons should keep in mind that the metastatic lymphadenopathy with extracapsular lymph node spread requires great caution during dissection and that a preoperative plan for conversion to thoracotomy can be useful in this case.

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Section: Techniquesmentioning

confidence: 99%

Lymphadenectomy during thoracoscopy: techniques and efficacy

Curcio

Amore

2017

J. Vis. Surg.

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“…is an endoscopic surgical spacer made of polyurethane sponge usable with a radiopaque marker.Our group developed it as a commercial product in collaboration with Hogy Medical Co., Ltd. Earlier reports have described the usefulness of SECUREA for laparoscopic procedures1,2 . The product was originally developed to permit the use of forceps to safely hold organs and tissues from the surgical field, to prevent the spread and facilitate the removal of exudate, and to prevent secondary injuries caused by surgical instruments.…”

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confidence: 99%

Invention of Two Instruments Fitted with SECUREA™ Useful for Laparoscopic Liver Resection

et al. 2016

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Laparoscopic liver resection (LLR) became common in Japan when advanced techniques and instruments for the procedure became available and the national medical insurance began covering partial resection and lateral segmentectomy. A successful LLR requires a gentle and powerful hold on the specimens, a steady operating field, and fast and rapid compression of the bleeding point to achieve hemostasis. In this paper we describe two instruments developed in our department by attaching the SECUREA™ endoscopic surgical spacer to the forceps and suction tube used for LLR. The instruments are useful and practical for any type of LLR, even in the hands of less experienced surgeons.

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