Videoendoscopic Pulmonary Resections

Roviaro, Giancarlo; Rebuffat, C.; Varoli, F.; Vergani, Contardo; Maciocco, M.; Scalambra, S.M.

doi:10.1007/978-3-662-01566-7_7

Cited by 122 publications

(137 citation statements)

References 4 publications

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“…In addition, the scope interferes with the other instruments in areas far from the camera port. Several recent reports have described uniportal VATS lobectomy (8)(9)(10)(11). However, uniportal VATS has the same drawbacks as does the look-up monitor setting.…”

Section: Discussionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting

et al. 2017

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“…VATS lobectomy was first reported in 1992 (7,8). In 20 years, VATS lobectomy has become a popular approach for thoracic disease.…”

Section: Commentsmentioning

confidence: 99%

Left upper lobectomy and systematic lymph nodes dissection in enlarged pulmonary hilar lymph nodes in primary lung cancer patient by uniportal video-assisted thoracic surgery

Fan

Yao

Chang

et al. 2016

ASVIDE

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Uniportal video-assisted thoracic surgery (VATS) anatomical pulmonary resection, with only one small incision for surgery instruments and camera insertion, requires higher operative skills, especially in the cases of the enlarged pulmonary hilar lymph nodes. With improved technology and increased experiences in VATS lobectomy, uniportal VATS lobectomy has been applied in major medical centers recently. A 67-year-old male patient with left upper peripheral lung cancer and enlarged hilar lymph nodes underwent unipotal VATS lobectomy and systemic mediastinal lymph node dissection. The patient recovered uneventfully. (Figure 1). Preoperative pathological examination of the lung lesion obtained by CT-guided percutaneous transthoracic needle biopsy indicated a poorly differentiated squamous cell carcinoma. The patient had coronary heart disease and the coronary artery DSA indicated 50% stenosis in left anterior descending (LAD). Left upper pulmonary lobectomy was performed. The operation took 171 minutes. During the operation, the estimated blood loss was 100 mL.On postoperative day (POD) 1, the amount of fluid drainage was 350 mL, and chest X-ray showed satisfied left lung inflation (Figure 2). The chest tube was removed on POD 4. The patient was discharged on POD 6 without complications. The tumor size was 4 cm in diameter, and the postoperative pathology confirmed lymph metastasis in station 5 ,11 and 13. Four cycles of adjuvant chemotherapy and radiotherapy were followed. Operative techniquesOperative position, insicion and instruments: the uniportal insicion were performed between the anterior axillary line and posterior axillary line over the fourth intercostal space about 4 cm in length ( Figure 3A). No rib spreader was used. A disposable, plastic wound retractor was used to stretch and protect the incision ( Figure 1B). A 30-degree, 10-mm high definition camera thoracoscope was placed at the posterior part of the incision during operation time for a panoramic view. To relieve the camera-man's hand tiredness, the thoracoscope bounded by a tape was fixed to the surgical drape ( Figure 3B). Both the surgeon and the camera-man stood in front of the patient and shared the same vision. VATS uses the same instruments as the conventional 3-port VATS dose (Figure 4). During dissection, we held a curving suction (Panther Healthcare, China) in left hand and an electrocautery hook or an ultra-sonic scalpel in the right hand.Operative key points and procedure ( Figure 5) (I) Mobilization of pulmonary vessels. The patient's interlobar fissure was complete. First we dissected the pulmonary artery in the interlobar fissure with ultrasonic scalpel or electrocautery hook and stapled the lingular atrey with a vascular (white cartridge, 45-mm-long) endostapler (EndoGIA, Covidien, USA). Then we dissected the interlobar lymph nodes (station 11). After the dissection of inter lobar fissure, the mediastinal pleura of the upper and anterior hilum was separated to isolate the anterior and apical segmental pulmonary arteries...

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“…The field has moved from the traditional extensive thoracotomy to a minimally invasive video-based approach for a wide array of pathologies with improved results, shorter hospital stays, less pain and reduced costs (1)(2)(3)(4). VATS technique reduced surgical trauma and maintains the same oncological principles of traditional open procedures (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracic surgery: the Middle East experience

et al. 2017

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Background: The application of uniportal video-assisted thoracic surgery (VATS) for both minor and major thoracic procedures is gaining widespread use across the globe. Believing its advantages, both in superb surgical results and less morbidity, our center has the privilege to be one of the first centers in the Middle East to introduce this surgical technique into our standard practice. This study presents our initial Results: The mean age of patients was 49.6 years, and 72 patients were females (37%). Thirty-five (18.2%) patients underwent anatomical resections with conversion to thoracotomy in three patients (8%). Six (3%) patients had air leak >4 days. The average chest drain duration was 3.25 days. The average length of stay was 4.2 days.Postoperative pain level was low in the first 4 days following the surgery and 30 days mortality was 0%.Conclusions: Uniportal VATS surgery is a safe and established technique with a minimal invasive thoracic surgery. Excellent results with minimal morbidity, short hospital stay and low postoperative pain are amongst its strong points. Thoracic surgeons experienced in thoracic surgical approaches can safely perform uniportal VATS.

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Videoendoscopic Pulmonary Resections

Cited by 122 publications

References 4 publications

Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting

Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting

Left upper lobectomy and systematic lymph nodes dissection in enlarged pulmonary hilar lymph nodes in primary lung cancer patient by uniportal video-assisted thoracic surgery

Uniportal video-assisted thoracic surgery: the Middle East experience

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