Uniportal video-assisted thoracoscopic right upper sleeve lobectomy and tracheoplasty in a 10-year-old patient

González-Rivas, Diego; Marin, Jessica Correa; Granados, Juan Pablo Ovalle; Llano, Juan David Urrea; Cañas, Sonia Roque; Arqueta, Alonso Oviedo; Torre, Mercedes de la

doi:10.21037/jtd.2016.08.06

Cited by 17 publications

(9 citation statements)

References 9 publications

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“…It could be more challenging to the surgeon for many reasons, including the difficulty of obtaining isolated lung ventilation due to the lack of a double-lumen endotracheal tube in young children, in addition to the lack of appropriate instruments with the curved tip specially designed for uniportal VATS operations. A few reports and studies have recently been published on the utilization of uniportal VATS for anatomical resections in pediatrics [7,[16][17][18] . However, the literature does not yet contain a report on subxiphoid uniportal VATS anatomical resection in a pediatric patient.…”

Section: Discussionmentioning

confidence: 99%

Subxiphoid uniportal video assisted thoracoscopic lobectomy in a pediatric patient

Akar¹,

Shaqqura²,

Rumman³

et al. 2020

MIS

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Thoracoscopic surgeries have witnessed tremendous and prompt recent development, especially in the field of uniportal video assisted thoracoscopic surgery (VATS) surgery. It is now possible to perform the most complex surgeries through this technique, which is of great benefit to the patient by significantly reducing the level of postoperative pain and complications of surgery. As surgeons gain experience in this field, their confidence and ability to push the limits and develop technologies are increasing. Performing uniportal VATS surgeries in children is a significant challenge for the surgeon due to the limited size of the thoracic cavity and the difficulty of the instrumentation. Here, we report the first case in the literature (as far as we know) of a uniportal Subxiphoid VATS lobectomy in a 2.5-year-old child. In conclusion, Subxiphoid uniportal VATS lobectomy is feasible in pediatric patients and may have some benefits over the intercostal approach.

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Section: Discussionmentioning

confidence: 99%

Subxiphoid uniportal video assisted thoracoscopic lobectomy in a pediatric patient

Akar¹,

Shaqqura²,

Rumman³

et al. 2020

MIS

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“…But the revolution in minimal invasive thoracoscopic techniques, which has recently emerged, has imposed itself strongly in this field due to its advantages in reducing the surgical trauma and postoperative pain (5,6). The publication of the report on the first uniportal VATS lobectomy performed by Diego Gonzalez-Rivas and his group published in 2011 has opened the way for more complex operations to be conducted by the same technique (7). This is what happened.…”

Section: Discussionmentioning

confidence: 99%

Right sleeve pneumonectomy via uniportal video-assisted thoracoscopic approach

et al. 2018

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“…Additional, compared with multi-ports VATS surgery, uniportal VATS possessed the advantages of small wound and cosmetology, especially for young women. Therefore, uniportal VATS was welcomed by more and more thoracic surgeon (11). According to the current conventional surgical instruments, 2 cm skin incision is the smallest minimally invasive surgery, operation is extremely difficult.…”

Section: Discussionmentioning

confidence: 99%

Uniportal video assisted thoracic surgery with 2 cm skin incision for right middle lobectomy with systematic lymphadenectomy

et al. 2017

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Today, video-assisted thoracic surgery (VATS) was very popular and more and more common, which could be carried out at all levels of medical centers, most of which used multiple-ports VATS techniques.However, uniportal VATS was more difficult technique compared with multiple-ports VATS, and was not yet completely universal. Uniportal port VATS with 2 cm incision was more difficult surgery, and asked the surgeon to master more surgical techniques and good collaborations with each other, however, which not only could reduce the postoperative pain and skin numbness but supply cosmetology and psychological comfort for patients. To reduce unnecessary damage to patients, we minimized the incision to 2 cm. Therefore, we called it precise uniportal port VATS technique in our surgical center and introduced it here. screening. Chest CT imaging showed a 15 mm × 13 mm solitary ground glass opacity (GGO) with air bronchogram in the right middle lobe, and mean CT value of the GGO was 618 Hu (Figure 1). He accepted standard antiinflammatory treatment for 2 weeks, then he was scanned with CT again, the lesion was same as before. Lung function was evaluated via formal spirometry with a FEV1 of 3.54 L (105.1% predicted), a FVC of 4.25 L (97.7% predicted), a FEV1/ FVC ratio of 83. 28% and MVV of 113.43 L (113.2% predicted). The bronchoscopy was examined and had no significant positive findings, but the patient refused steadfastly CT-guided biopsy. Therefore, he was examined with a positron emission tomography and computerized tomography scan (PET-CT) preoperatively to ensure that there was no evidence of metastatic disease. Surgery proceduresAs there are no changes for the lesion in the patient after standard anti-inflammatory treatment for two weeks, the density and form of GGO look like malignant lesion, moreover, the lesion located in the region of the hilar, and cannot be had wedge resection for frozen pathological examination, so we decided to make right middle lobectomy directly, and we had a radical lymphadenectomy after frozen pathology revealed adenocarcinoma. Anesthesia and positioningThe patient was placed in the left lateral decubitus position with the upper arms extended to 90° and the forearms and hands covered his head without universal screen and arm board (Figure 2). To gain more operative space and protect the intercostal neurovascular bundles, a soft pillow was put under the left side of chest. General anesthesia was completed and intubation was achieved via a double lumen endobronchial tube. The surgeon and the assistant stood on both sides of the patient respectively to maintain the same thoracoscopic vision during all steps of surgery and to experience more coordinated movements. Usually, the surgeon held the suction tool in the left hand and the coagulation hook in the right hand. One assistant held the thoracoscope in two hands intently, another assistant operated endoscopic grasper and so on (Figure 3). PortsThe skin incision, approximate 2 cm long in diameter (Figure 4), was operated in the 4 t...

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Uniportal video-assisted thoracoscopic right upper sleeve lobectomy and tracheoplasty in a 10-year-old patient

Cited by 17 publications

References 9 publications

Subxiphoid uniportal video assisted thoracoscopic lobectomy in a pediatric patient

Subxiphoid uniportal video assisted thoracoscopic lobectomy in a pediatric patient

Right sleeve pneumonectomy via uniportal video-assisted thoracoscopic approach

Uniportal video assisted thoracic surgery with 2 cm skin incision for right middle lobectomy with systematic lymphadenectomy

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