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Technique of pulmonary lobectomy

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https://www.readbyqxmd.com/read/29445603/uniportal-video-assisted-thoracic-lung-segmentectomy-with-near-infrared-indocyanine-green-intersegmental-plane-identification
#1
Elisa Meacci, Dania Nachira, Maria Teresa Congedo, Marco Chiappetta, Leonardo Petracca Ciavarella, Stefano Margaritora
In the era of lung cancer screening and early detection of lung lesions, pulmonary segmentectomy has gained wide acceptance between thoracic community reducing the need of lobectomy for diagnostic purpose and treatment in case of centrally located benign, multiple or undetermined lesions. In rigorously selected patients with stage I non-small cell lung cancer (NSCLC), segmentectomies seem to offer similar survival outcomes rather than lobectomies, but associated with a better conservation of lung function. However, segmentectomy is a more challenging procedure to be performed compared to lobectomy, especially by video-assisted thoracic surgery (VATS)...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29381881/the-bronchus-first-and-vessels-simultaneously-stapled-technique-a-safe-and-simple-method-for-video-assisted-right-upper-lobe-lobectomy
#2
Hao Xu, Linyou Zhang
OBJECTIVE:  Video-assisted thoracic surgery lobectomy is a minimally invasive procedure for major pulmonary resection. The purpose of this study was to present a novel approach with a thoracoscope in the right upper lobe and to compare different lobectomy methods at our institution. METHODS:  We reviewed the medical records of patients who underwent a thoracoscopic right upper lobectomy for lung cancer between September 2015 and September 2016. We performed 128 thoracoscopic right upper lobectomies: group A (n = 50) was treated with the bronchus-first and vessels simultaneously stapled method and group B (n = 78) was treated with the conventional isolation-ligation method...
January 30, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29370414/robotic-right-middle-lobectomy-with-a-subxiphoid-utility-port
#3
Shruti Jayakumar, Marco Nardini, Pavlos Papoulidis, Joel Dunning
We present the case of a 74-year-old man with Stage IIa pulmonary adenocarcinoma, for which he underwent a robotic right middle lobectomy. A 4-armed, 5-port approach was used. Four intercostal ports were created above the ninth rib using the Cerfolio's technique. The subxiphoid port was created in the midline, 5 cm down from the xiphisternum. The robot offers higher image quality, depth perception and improved articulation of the instruments, allowing for more accurate dissection and stitching. The usage of a subxiphoid utility port reduces the clashing between instruments, offers a good angle for stapling and provides a direct view of the instruments entering into the chest...
January 23, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29312746/-five-on-a-dice-port-placement-for-robot-assisted-thoracoscopic-right-upper-lobectomy-using-robotic-stapler
#4
Min P Kim, Edward Y Chan
Early versions of the da Vinci robot system (S and Si) have been used to perform pulmonary lung resection with severe limitations. The lack of a vascular robot stapler required the presence of a trained bedside assistant whose role was to place, manipulate and fire the stapler around major vascular structures. Thus, the techniques developed for the Si robot required a skilled bedside assistant to perform stapling of the hilar structure and manipulation of the lung. With the advent of the da Vinci Xi system with a vascular robot stapler, we postulated that we could develop a new port placement and technique to provide total control for the surgeon during the pulmonary lung resection...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29300072/thoracoscopic-right-upper-lobectomy-after-an-initial-anatomic-pulmonary-resection-of-the-lower-lobe
#5
Hitoshi Igai, Mitsuhiro Kamiyoshihara, Natsuko Kawatani, Kimihiro Shimizu
It is challenging to redo an anatomical pulmonary resection on the ipsilateral side because of the adhesions or dense fissures caused by the initial anatomic pulmonary resection. Few reports describe surgical techniques for addressing these challenges, especially using a minimally invasive thoracoscopic approach instead of standard thoracotomy. Here, we demonstrate a thoracoscopic right upper lobectomy after an initial anatomic pulmonary resection of the right lower lobe and explain the nuances of performing it...
November 14, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29224266/-application-of-liver-three-dimensional-visualization-technologies-in-the-treatment-planning-of-hepatic-malignant-tumor
#6
P P Li, Z H Wang, G Huang, Z P Huang, Y Li, J S Ni, H Liu, C H Fang, W P Zhou
Objective: To discuss the application of three dimentional(3D)visualization technologies in treatment plan of hepatic malignant tumor. Methods: The clinical data of 300 patients with liver malignant tumor who received treatment from January 2016 to January 2017 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital was retrospectively analyzed in this study, including 221 male and 79 female patients aged from 7 to 76 years with median age of 54 years. The median height was 168 cm (115-183 cm), the median weight was 65 kg (20-105 kg) and the median tumor volume was 142 ml (23-2 493 ml)...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29221315/four-arm-robotic-assisted-pulmonary-resection-right-upper-lobectomy-how-to-do-it
#7
Alessandro Pardolesi, Luca Bertolaccini, Jury Brandolini, Piergiorgio Solli
Numerous published articles have shown the safety and efficacy of robotic lung resection, including lobectomy. Several techniques have been described by different authors to perform a robot assisted lung lobectomy. We adopted four arms robotic procedure. We usually perform three ports (10-15 mm) and an anterior 3 to 4 cm utility incision. This technique allows to safely proceed with an anterior to posterior approach to the hilum. In this study, we present in clear and sequential steps, the procedure to perform a right upper lobectomy for early stage lung cancer...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221306/systemic-tunnel-dissection-of-mediastinal-lymph-nodes-without-clamping-via-uniportal-video-assisted-thoracoscopic-surgery
#8
Jia-Tao Zhang, Song Dong, Xue-Ning Yang, Yi-Long Wu, Wen-Zhao Zhong
Here we introduce a manual tunnel approach to remove the mediastinal lymph nodes and highlight the conception of non-clamping during dissection. We describe two cases of pulmonary malignancy performing a strategic lobectomy and systemic dissection of mediastinal lymph nodes via single port. The technique of tunnel dissection without clamping ensure to satisfy the requirement of oncology and clinical criteria. By efficiently specifying surgery procedure and improving dissection thoroughness, our approach should be implemented...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221302/the-society-for-translational-medicine-clinical-practice-guidelines-for-mechanical-ventilation-management-for-patients-undergoing-lobectomy
#9
REVIEW
Shugeng Gao, Zhongheng Zhang, Alessandro Brunelli, Chang Chen, Chun Chen, Gang Chen, Haiquan Chen, Jin-Shing Chen, Stephen Cassivi, Ying Chai, John B Downs, Wentao Fang, Xiangning Fu, Martínez I Garutti, Jianxing He, Jie He, Jian Hu, Yunchao Huang, Gening Jiang, Hongjing Jiang, Zhongmin Jiang, Danqing Li, Gaofeng Li, Hui Li, Qiang Li, Xiaofei Li, Yin Li, Zhijun Li, Chia-Chuan Liu, Deruo Liu, Lunxu Liu, Yongyi Liu, Haitao Ma, Weimin Mao, Yousheng Mao, Juwei Mou, Calvin Sze Hang Ng, René H Petersen, Guibin Qiao, Gaetano Rocco, Erico Ruffini, Lijie Tan, Qunyou Tan, Tang Tong, Haidong Wang, Qun Wang, Ruwen Wang, Shumin Wang, Deyao Xie, Qi Xue, Tao Xue, Lin Xu, Shidong Xu, Songtao Xu, Tiansheng Yan, Fenglei Yu, Zhentao Yu, Chunfang Zhang, Lanjun Zhang, Tao Zhang, Xun Zhang, Xiaojing Zhao, Xuewei Zhao, Xiuyi Zhi, Qinghua Zhou
Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221295/contralateral-thoracoscopic-lobectomy-in-postlobectomy-patients
#10
Manabu Yasuda, Ryoichi Nakanishi, Shinji Shinohara, Masataka Mori, Syuhei Ashikari, Tsunehiro Oyama, Takeshi Hanagiri
Background: It is difficult to perform thoracoscopic lobectomy in patients with a history of contralateral lobectomy, as stable oxygenation is not always maintained under conditions of one-lung ventilation during surgery. Methods: This study evaluated 14 patients who underwent thoracoscopic lobectomy after previously undergoing contralateral lobectomy at a single institution between 2008 and 2015. Results: Among 14 patients who had previously received contralateral lobectomy, 4 were unable to maintain sufficient perioperative oxygenation with usual one-lung ventilation...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29217900/pulmonary-function-after-lobectomy-video-assisted-thoracoscopic-surgery-versus-muscle-sparing-mini-thoracotomy
#11
Katsuo Usuda, Sumiko Maeda, Nozomu Motomo, Makoto Tanaka, Masakatsu Ueno, Yuichiro Machida, Motoyasu Sagawa, Hidetaka Uramoto
Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3-4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7-12-cm skin incision spread by rib retractors made of metal and one or two trocars...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29203261/preoperative-computed-tomography-guided-pulmonary-lesion-marking-in-preparation-for-fluoroscopic-wedge-resection-rates-of-success-complications-and-pathology-outcomes
#12
Babatunde Olaiya, Charles A Gilliland, Seth D Force, Felix G Fernandez, Manu S Sancheti, William C Small
PURPOSE: In this study, we describe our experience of lesion marking with fiducial markers (FM) and microcoils (MC) facilitating same-day surgical wedge resection, including success rates, pathology outcomes, and complications. We also explored patient/nodular characteristics associated with developing complications. MATERIALS AND METHODS: An IRB-approved single-institutional retrospective study of 136 patients who had 148 pulmonary nodules was conducted. All patients had CT-guided pulmonary nodule labeling with either FM (121) or MC (15) patients with plan for same-day fluoroscopic-guided wedge resection...
November 6, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29136038/midterm-outcomes-of-single-port-thoracoscopic-surgery-for-major-pulmonary-resection
#13
Kook Nam Han, Hyun Koo Kim, Young Ho Choi
INTRODUCTION: Single-port thoracoscopic surgery has widened the current minimally invasive surgical techniques toward more less invasive procedures in terms of reducing the number of incisions. However, the current status of oncologic outcome with this technique is not well known for lung cancer surgery. The purpose of this study is to evaluate the oncologic outcomes in early stage lung cancer for impact of the survival outcomes with our experience of conversion to a single-port approach from the conventional three-port approach...
2017: PloS One
https://www.readbyqxmd.com/read/29119018/metastasectomy-in-pediatric-patients-indications-technical-tips-and-outcomes
#14
REVIEW
Paolo Scanagatta, Lara Girelli
Pulmonary metastasectomy has become a standard procedure for pediatric patients with certain types of solid tumors. Surgeons, expert pediatric oncologists and radiation oncologists contribute with their different skills to the management of pulmonary metastases. Patients are usually scheduled for surgery in case of primary tumor control, in absence of metastases in other organs and when a complete resection is achievable. Nodules are removed through precision resections using electrocautery or laser methods in order to ensure radical surgery with adequate margins...
October 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29078698/needlescopic-assisted-uniportal-video-assisted-thoracoscopic-pulmonary-anatomical-segmentectomy
#15
Shun-Mao Yang, Wen-Ting Wu, Yu-Hsuan Liu, Huan-Jang Ko
BACKGROUND: Pulmonary segmentectomy can be an oncologic equivalent of lobectomy for small non-small cell lung cancer. Uniportal video-assisted thoracoscopic surgery (VATS) has recently showed favorable surgical outcomes, but remains technical demanding, especially in a complex procedure like anatomic segmentectomy. This manuscript demonstrates the surgical techniques for uniportal VATS segmentectomies with the assistance of additional needlescopic instruments. METHODS: Data of 22 consecutive patients who underwent 24 needlescopic-assisted uniportal VATS segmentectomies between December 2016 and June 2017 was analyzed...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078680/nonintubated-uniportal-vats-pulmonary-anatomical-resections
#16
REVIEW
Carlos Galvez, Jose Navarro-Martinez, Sergio Bolufer, Francisco Lirio, Julio Sesma, Juan Manuel Corcoles
Nonintubated procedures have widely developed during the last years, thus nowadays major anatomical resections are performed in spontaneously breathing patients in some centers. In an attempt for combining less invasive surgical approaches with less aggressive anesthesia, nonintubated uniportal video-assisted thoracic surgery (VATS) lobectomies and segmentectomies have been proved feasible and safe, but there are no comparative trials and the evidence is still poor. A program in nonintubated uniportal major surgery should be started in highly experienced units, overcoming first a learning period performing minor procedures and a training program for the management of potential crisis situations when operating on these patients...
2017: Journal of visualized surgery
https://www.readbyqxmd.com/read/29078672/robotic-lobectomies-when-and-why
#17
REVIEW
Sara Ricciardi, Giuseppe Cardillo, Carmelina Cristina Zirafa, Federico Davini, Franca Melfi
During the last decade, an abundance of papers has supported minimally invasive pulmonary resections (MIPR) vs. traditional open approach. Both video assisted thoracic surgery (VATS) and robotic thoracic surgery have shown better perioperative outcomes and equivalent oncologic results compared with thoracotomy, confirming the effectiveness of the MIPR. Despite the profound changes and improvements that have taken place throughout the years and the increasing use of robotic system worldwide, the controversy about the application of robotic surgery for lung resections is still open...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078667/uniportal-video-assisted-thoracic-surgery-for-pneumothorax-and-blebs-bullae
#18
REVIEW
Luca Bertolaccini, Alessandro Pardolesi, Jury Brandolini, Piergiorgio Solli
The last British Society of Thoracic Surgeons guidelines of 2010 for the management of primary spontaneous pneumothorax (PSP) stated that, after the first recurrence, the treatment of PSP should be a surgical operation, like a bullectomy accompanying with a procedure for inducing pleural adhesions. Therefore, the surgical approach is considered the best treatment to minimise the risk of recurrence in patients who experienced a PSP. There is substantial evidence in the literature demonstrating that the minimally invasive approach should be preferred to the thoracotomic procedure since it can reduce the postoperative pain and it is associated with a faster recovery of the physical and working activity...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078618/transition-from-video-assisted-thoracic-surgery-to-robotic-pulmonary-surgery
#19
REVIEW
Takashi Suda
The "da Vinci Surgical System" is a robotic surgical system that utilizes multi-jointed robotic arms and a high-resolution three-dimensional video-monitoring system. We report on the state of transition from video-assisted thoracoscopic surgery (VATS) to robotic pulmonary surgery, the surgical outcomes of robotic surgery compared to VATS, and the future of robotic surgery. Surgery utilizing the da Vinci Surgical System requires a console surgeon and assistant who have been certified by Intuitive Surgical, Inc...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078614/intra-pericardial-double-sleeve-uniportal-video-assisted-thoracoscopic-surgery-left-upper-lobectomy
#20
Firas Abu Akar, Chenlu Yang, Lei Lin, Shi Jia Min, Lei Jiang
The importance of parenchymal tissue preservation during lung resections is well realized in thoracic surgery. Technical refinement and anatomic insight have expanded indications for parenchymal -sparing surgeries. In thoracic surgery, it's reasonable to avoid pneumonectomy whenever it's possible, although challenging and technically more demanding than standard anatomic pulmonary resection, bronchial and/or vascular resection of a circumferential portion (sleeve resections) is a justified procedure due to its benefits of avoiding the complications of pneumonectomy in addition to preservation of pulmonary tissue and functions...
2017: Journal of Visualized Surgery
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