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Technique of pulmonary lobectomy

Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Akihiro Aoyama, Hideki Motoyama, Kyoko Hijiya, Toshi Menju, Toshihiko Sato, Makoto Sonobe, Hiroshi Date
OBJECTIVES: Donor lobectomies in living-donor lobar lung transplantation sometimes require additional surgical procedures on the interlobar pulmonary artery. We retrospectively reviewed the surgical techniques and outcomes of living-donor lobectomy. METHODS: Between 2008 and 2015, 116 living-donor lobectomies were performed in 64 consecutive living-donor lobar lung transplantations (52 bilateral, 12 single). The surgical techniques and outcomes were reviewed retrospectively...
October 15, 2016: European Journal of Cardio-thoracic Surgery
Steven Rothenberg
PURPOSE: Thoracoscopic lobectomy for congenital cystic lung disease has become an accepted and in many institutions the preferred technique. However, the technical challenges are many. Previous endoscopic staplers (12 mm) used commonly in adults are too large for use in infants This study evaluates the safety and efficacy of using a 5 mm stapling device to seal and divide major pulmonary structures. METHODS: From July 2014 to March 2016, 26 patients of age 6 weeks to 13 months underwent thoracoscopic lobectomy for CPAM or sequestration...
October 5, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Akihiro Aoyama, Hiroshi Date
In living-donor lobar lung transplantation, donor lobectomies must be performed carefully both for donors and recipients. In some cases pulmonary arterioplasty is required for preserving branches of pulmonary artery. This report describes a successful case of pulmonary arterioplasty with end-to-end anastomosis of the interlobar artery and the lingular branch in living-donor lobectomy. Because the harvest of autologous pericardium can be avoided both in donor and recipient surgical procedures by using this technique, living-donor lobar lung transplantation can be performed more safely and simply...
October 2016: Annals of Thoracic Surgery
Min Zhang, Alan D L Sihoe, Ming Du
BACKGROUND: Single-port video-assisted thoracoscopic surgery (VATS) left upper lobectomy is difficult amongst all the lobes. At the beginning of single-port lobectomies, the upper lobes were believed not to be amenable for single-port approach due to the difficult angulation for staplers. Gonzalez reported the first single-port VATS left upper lobectomy in 2011. METHODS: We report a new technique of single-port VATS left upper lobectomy with the concept of "reverse direction"...
August 2016: Journal of Thoracic Disease
Hao Chen, Guobing Xu, Bin Zheng, Wei Zheng, Yong Zhu, Zhaohui Guo, Chun Chen
BACKGROUND: In this study, we evaluate the feasibility and safety of single-port video-assisted thoracoscopic surgery (VATS) sleeve lobectomy (SL) and systematic mediastinal lymphadenectomy and summarize our surgical experience. METHODS: From October 2014 to December 2015, eight cases of single-port VATS SL [seven male patients and one female patient, median age 56.0 (range, 38-63) years] were performed by a single group of surgeons in Fujian Medical University Fujian Union Hospital...
August 2016: Journal of Thoracic Disease
Laura L Donahoe, Elsie T Nguyen, Tae-Bong Chung, Lan-Chau Kha, Marcelo Cypel, Gail E Darling, Marc de Perrot, Shaf Keshavjee, Andrew F Pierre, Thomas K Waddell, Kazuhiro Yasufuku
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is standard of care for small lung resections at many centres. Computed tomography (CT)-guided insertion of microcoils can aid surgeons in performing VATS resections for non-palpable lung nodules deep to the lung surface. METHODS: Retrospective analysis of CT-guided microcoil insertions prior to VATS lung resection at a single institution from October 2008 to January 2014. RESULTS: A total of 63 patients were included (37% male, mean age 61...
August 2016: Journal of Thoracic Disease
Valerie Lacroix, Zahra Mosala Nezhad, David Kahn, Arnaud Steyaert, Alain Poncelet, Thierry Pieters, Philippe Noirhomme
Background To evaluate pulmonary function, pain, and quality of life at midterm after robotic lobectomy performed in a single institution. Methods Sixty-five consecutive patients underwent robotic thoracic surgery over 32 months using a complete four-arm portal technique. Sixty-one patients underwent lobectomies predominantly for stage I non-small cell lung cancer. Pulmonary function tests were repeated at midterm follow-up. Pain and quality of life were evaluated during the follow-up on a subgroup of 39 patients, excluding the learning period...
August 30, 2016: Thoracic and Cardiovascular Surgeon
Jane Keating, Sunil Singhal
Lung cancer screening has lead to frequent diagnosis of solitary pulmonary nodules, many of which require surgical biopsy for diagnosis and intervention. Subcentimeter and central nodules are particularly difficult to visualize or palpate during surgery, thus nodule localization can be a difficult problem for the thoracic surgeon. Although minimally invasive techniques including transthoracic computed tomography and bronchoscopic-guided biopsy may establish a diagnosis, these methods do not help locate nodules during surgery and can lead to inadequate tissue sampling...
2016: Seminars in Thoracic and Cardiovascular Surgery
Dietrich Doll, Markus Eichler, Pantelis Vassiliu, Kenneth Boffard, Tim Pohlemann, Elias Degiannis
BACKGROUND: Penetrating trauma is becoming increasingly common in parts of the world where previously it was rare. At the same time, general surgeons and surgical trainees are becoming more specialized, and less comfortable operating within areas beyond their zone of specialization. OBJECTIVE: The purpose of this manuscript is to assess the technical difficulties encountered in operating on patients who have sustained penetrating trauma, and to prove to general surgeons that the technical skills and techniques required are no different to those required for abdominal surgery, and do not require additional dexterity...
August 23, 2016: World Journal of Surgery
Jonathan D Spicer, Jitesh B Shewale, Mara B Antonoff, Arlene M Correa, Wayne B Hofstetter, David C Rice, Ara A Vaporciyan, Reza J Mehran, Garrett L Walsh, Jack A Roth, Stephen G Swisher, Boris Sepesi
BACKGROUND: Emerging technologies for prosthetic reconstruction after chest wall resection have yielded a wide variety of reconstructive options for thoracic surgeons. The ideal chest wall reconstruction and its impact on perioperative outcomes has not been well defined. Our goal was to determine whether mesh characteristics such as rigidity or absorbability altered perioperative pulmonary and infectious outcomes. METHODS: Our institutional database was queried for patients who underwent chest wall resection and reconstruction for primary or secondary chest wall tumors between the years 1998 and 2013...
August 12, 2016: Annals of Thoracic Surgery
Marco Chiarelli, Martino Gerosa, Angelo Guttadauro, Francesco Gabrielli, Giuseppe Vertemati, Massimo Cazzaniga, Luca Fumagalli, Matilde De Simone, Ugo Cioffi
BACKGROUND: The majority of patients with severe blunt chest trauma is successfully treated with supportive measures and thoracostomy tube; only few cases need urgent thoracotomy. Lung-sparing techniques are treatments of choice but major pulmonary resections are necessary in case of injuries involving hilar vessels or bronchi. Currently the mortality associated with pulmonary lobectomy performed for chest trauma is 40%. METHODS: Over a 2-year period [2013-2014], 210 patients with chest trauma were hospitalized at our Institution...
July 2016: Journal of Thoracic Disease
Yubao Guan, Jun Huang, Tingting Xia, Xiaoting You, Jiaxi He, Jianxing He
BACKGROUND: To investigate the estimated value of spiral computed tomography (CT) post-processing techniques in preoperative stage T3, central-type non-small cell lung cancer (NSCLC) with double sleeve lobectomy under complete video-assisted thoracoscopic surgery (c-VATS). METHODS: Preoperative clinical date and CT reconstructed data of 10 patients who underwent double sleeve lobectomy with upper lobe stage T3, central-type NSCLC were retrospectively analysed and compared to surgical pathological results and cross-sectional CT data...
July 2016: Journal of Thoracic Disease
Martin Reichert, Andrea Birgitta Gohlke, Florian Augustin, Dietmar Öfner, Andreas Hecker, Winfried Padberg, Johannes Bodner
PURPOSE: Video-assisted thoracoscopic surgery (VATS) is an accepted alternative to thoracotomy for anatomic lung resection (AR) and literature suggests benefits over the conventional open approach. However, it's routine clinical application is still low and varies within different countries. METHODS: Nationwide survey among thoracic surgical units in Germany, evaluating the departmental structure, volume of the VATS program, experience with VATS-AR (lobectomies and other-than-lobectomies-anatomic-resections), surgical technique and learning curve data...
September 2016: Langenbeck's Archives of Surgery
Makoto Sonobe, Hiroshi Date
Recently, lung cancer patients who cannot undergo lobectomy because of impaired pulmonary function, co-morbidity, and/or advanced age are increasing. And patients whose lung cancer is small in size, peripherally located, and assumed to be N0 disease are also increasing. Therefore, we have a greater opportunity to perform sublobar lung resection for these patients. For sublobar resection, several surgical technologies have been developed. Virtual-assisted lung mapping (VAL-MAP) is bronchoscopic multiple dye-marking technique under support of 3-dimensional virtual images to provide geometric information on the lung surface...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
O Valencia Orgaz, M I Real Navacerrada, M Cortés Guerrero, A F García Gutierrez, C Marrón Fernández, F Pérez-Cerdá Silvestre
Lung isolation is essential during thoracic surgery, as it allows the thoracic surgeon to visualise and work in the surgical field. The occurrence of hypoxaemia during lung isolation is common, and is even more so in patients with decreased pulmonary functional reserve. The clinical cases are presented of 2 patients with a history of left pulmonary resections (1st left lower lobectomy, 2nd left lower lobectomy and left upper lobe segmentectomy), in which sequential selective lobar blockade was performed with Fuji Uniblocker(®) endobronchial blocker for performing right lung atypical resections (right upper lobe, middle lobe, and right lower lobe)...
July 12, 2016: Revista Española de Anestesiología y Reanimación
Colin D Gause, Grace Hsiung, Ben Schwab, Matthew Clifton, Carroll M Harmon, Katherine A Barsness
BACKGROUND: Mandates for improved patient safety and increasing work hour restrictions have resulted in changes in surgical education. Educational courses increasingly must meet those needs. We sought to determine the experience, skill level, and the impact of simulation-based education (SBE) on two cohorts of pediatric surgery trainees. MATERIALS AND METHODS: After Institutional Review Board (IRB) exempt determination, a retrospective review was performed of evaluations for an annual advanced minimally invasive surgery (MIS) course over 2 consecutive years...
August 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Eric Goudie, Mohamed Khereba, Mehdi Tahiri, Pravachan Hegde, Vicky Thiffault, Rachid Hadjeres, Jérémie Berdugo, Pasquale Ferraro, Moishe Liberman
BACKGROUND: Pulmonary artery (PA) sealing in video-assisted thoracoscopic surgery (VATS) lobectomy is typically accomplished using vascular endostaplers. Endostaplers may be associated with iatrogenic PA branch injury, especially in short, small PA branches. We evaluated PA branch sealing with the HARMONIC ACE +7 (ACE) shears (Ethicon, Cincinnati, OH) in VATS lobectomy in a canine survival model. METHODS: Ten adult dogs underwent VATS lobectomy. Standard VATS lobectomy operative technique was used for the entire operation, except for PA branch sealing...
October 2016: Annals of Thoracic Surgery
Robert J Cerfolio, Kyle M Bess, Benjamin Wei, Douglas J Minnich
BACKGROUND: Our objective is to report our incidence, results, and technique for the control of major vascular injuries during minimally invasive robotic thoracic surgery. METHODS: This is a consecutive series of patients who underwent a planned robotic thoracic operation by one surgeon. RESULTS: Between February 2009 and September 2015, 1,304 consecutive patients underwent a robotic operation (lobectomy, n = 502; segmentectomy, n = 130; mediastinal resection, n = 115; Ivor Lewis, n = 103; thymectomy, n = 97; and others, n = 357) by one surgeon...
August 2016: Annals of Thoracic Surgery
Liang Chen, Weibing Wu
Thoracoscopic segmentectomy is technically much more meticulous than lobectomy, due to the complicated anotomical variations of segmental bronchi and vessels. Preoperative three-dimensional computed tomography bronchography and angiography, 3D-CTBA) could reveal the anatomical structures and variations of the segmental bronchi/vessels and locate the pulmonary nodules, which is helpful for surgery planning. Preoperative nodule localization is of vital importance for thoracoscopic segmentectomy. Techniques involved in this procedure include dissection of the targeted arteries, bronchus and intra-segmental veins, retention of the inter-segmental veins, identification of the inter-segmental boarder with the inflation-deflation method and seperation of intra-segmental pulmonary tissues by electrotome and/or endoscopic staplers...
June 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Hidenori Kawasaki, Yasuji Oshiro, Naohiro Taira, Tomonori Furugen, Takaharu Ichi, Tomofumi Yohena, Tsutomu Kawabata
A 45-year-old man had an abnormal shadow in the right lung field on an annual screening chest X-ray. He was diagnosed with Stage IA (cT1bN0M0) lung cancer. Initially, we did not notice an anomalous vein on non-contrast computed tomography. However, we found that the right upper lobe bronchus branched from the lateral wall of the right main bronchial orifice, above the level of the common right upper lobe bronchus. Therefore, the bronchus was thought to be a tracheal bronchus. We carefully reevaluated the patient using three-dimensional computed tomography angiography...
June 16, 2016: Annals of Thoracic and Cardiovascular Surgery
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