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Techniques of lung lobectomy

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https://www.readbyqxmd.com/read/29312746/-five-on-a-dice-port-placement-for-robot-assisted-thoracoscopic-right-upper-lobectomy-using-robotic-stapler
#1
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/29312734/posterior-uniportal-video-assisted-thoracoscopic-surgery-for-anatomical-lung-resections
#2
Davor Stamenovic, Korkut Bostanci, Antje Messerschmidt
Background: The acceptance of uniportal video-assisted thoracoscopic surgery (uVATS) for anatomical lung resections has been growing in recent years. This study presents the first case-series in the literature with posterior uVATS (puVATS) technique for specific anatomical lung resections. Methods: The first 20 consecutive patients who underwent an anatomical lung resection by a single surgeon, by means of puVATS technique were evaluated in terms of pre-, peri- and post-operative results...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29249491/laparoscopic-transdiaphragmatic-chest-surgery-early-experience
#3
Rafael Santiago Andrade, Ilitch Diaz-Gutierrez, Jacob Hutchins, Alexander Kaizer, Joseph Small, Madhuri Rao
OBJECTIVE: We describe laparoscopic transdiaphragmatic (LTD) chest surgery without intercostal incisions and focus on technique and safety. The goal of LTD is to minimize postoperative pain. METHODS: We reviewed all patients undergoing LTD chest surgery (September 8, 2010-April 4, 2017). We place 4 abdominal ports with the patient in semilateral decubitus, make 2 diaphragmatic openings, and advance 2 ports into the chest. The intrathoracic operation is standard video-assisted thoracoscopic surgery (VATS), and diaphragmatic openings are closed at the end...
November 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29221315/four-arm-robotic-assisted-pulmonary-resection-right-upper-lobectomy-how-to-do-it
#4
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/29221310/uniportal-video-assisted-thoracoscopic-surgery-left-upper-lobe-trisegmentectomy-using-flexible-tip-3d-video-scope
#5
Mathew Thomas
A 69-year-old male patient with a history of melanoma and prostate cancer was found to have a 2.6 cm PET-avid, slowly enlarging, left upper lobe lung nodule that was suspicious for either metastasis or primary lung cancer. Due to the deep location of the nodule, a wedge resection was not recommended. A diagnostic and therapeutic uniportal video-assisted thoracoscopic surgery (U-VATS) left upper lobe trisegmentectomy was performed uneventfully. Final pathology confirmed the presence of metastasis from prostate cancer without lymph node involvement...
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
#6
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
#7
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/29180212/patterns-of-elective-lobectomy-for-lung-cancer
#8
Bian Liu, Raja M Flores, Emanuela Taioli
BACKGROUND: Lobectomy is the recommended treatment for early-stage lung cancer. Little is known about variations of access to health service areas and hospital types for lobectomy overall and according to specific surgical techniques, such as the video-assisted thoracoscopic surgery (VATS). METHODS: The New York Statewide Planning and Research Cooperative System (2007-2012) was queried for lung cancer patients who underwent elective lobectomy. Hospitals were defined as nearest high-volume hospital (nHVH, reference), distant HVH (dHVH), close or distant low-volume hospital (cLVH or dLVH) using lobectomy volume and travel burden by the distance to nHVH...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29159658/lung-necrosectomy-in-pediatric-patients-with-necrotizing-pneumonia
#9
Francina V Bolaños-Morales, Emmanuel Peña Gómez-Portugal, María E Aguilar-Mena, Patricio J Santillán-Doherty, Avelina Sotres-Vega, J Alfredo Santibáñez-Salgado
INTRODUCTION: Necrotizing pneumonia is the consolidation of lung parenchyma with destruction and necrosis, forming solitary or multiloculated radiolucent foci. When antibiotic treatment fails and clinical course does not improve, patients might need lung tissue resection: segmentectomy, lobectomy or bilobectomy. We have performed a more conservative surgical approach in pediatric patients with necrotizing pneumonia, lung necrosectomy: resection of unviable necrotic tissue, to preserve more healthy and potentially recoverable lung parenchyma...
November 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29136038/midterm-outcomes-of-single-port-thoracoscopic-surgery-for-major-pulmonary-resection
#10
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
#11
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
#12
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/29078692/robotic-lobectomy
#13
Paul Linsky, Benjamin Wei
Lobectomy is still currently the gold standard for treatment of lung cancer. With the great advancement of robotic surgery, robotic lobectomy has been demonstrated to be an operation that is safe and can be done in a timely manner, similar to video-assisted thoracoscopic surgery (VATS). Additionally, reports show that long-term oncologic outcomes for robotic lobectomy are consistent with those reported for VATS and open lobectomy. Patients are selected in the same manner as those for VATS. Improved optics, increased dexterity of the instruments, and better ergonomics can yield subjective advantages to the surgeon...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078686/uniportal-video-assisted-thoracoscopic-surgery-in-hemothorax
#14
REVIEW
Stefano Sanna, Luca Bertolaccini, Jury Brandolini, Desideria Argnani, Marta Mengozzi, Alessandro Pardolesi, Piergiorgio Solli
The management of hemothorax (spontaneous or, more often, due to thoracic trauma lesions), follows basic tenets well-respected by cardiothoracic surgeons. In most, a non-operative approach is adequate and safe, with a defined group of patients requiring only tube thoracostomy. Only a minority of patients need a surgical intervention due to retained hemothorax, persistent bleeding or incoming complications, as pleural empyema or entrapped lung. In the early 1990s, the rapid technological developments determined an increase of diagnostic and therapeutical indications for multiport video-assisted thoracoscopic surgery (VATS) as the gold standard therapy for retained and persistent hemothorax, allowing an earlier diagnosis, total clots removal and better tubes placement with less morbidity, reduced post-operative pain and shorter hospital stay...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078677/uniportal-video-assisted-thoracoscopic-surgery-vats-technique-is-associated-with-decreased-narcotic-usage-over-traditional-vats-lobectomy
#15
Scott Gregory Louis, William James Gibson, Chase Lynn King, Nirmal Kumar Veeramachaneni
BACKGROUND: Uniportal video-assisted thoracoscopic surgery (VATS) is gaining popularity internationally, but remains an uncommon practice in the United States. One proposed benefit is a decrease in narcotic usage and peri-operative pain when compared to traditional multiple incision VATS. The purpose of this study was to determine the post-operative narcotic usage between patients undergoing anatomic lobectomy via traditional VATS as compared to patients undergoing uniportal VATS. METHODS: All consecutive patients undergoing anatomic lobectomy for presumed malignancy by a single surgeon at an academic medical institution were recorded between July 2013 and September 2015...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078672/robotic-lobectomies-when-and-why
#16
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/29078665/steps-in-the-development-of-a-vats-lobectomy-program
#17
Dario Amore, Carlo Curcio
Video-assisted thoracoscopic surgery (VATS) lobectomy has been employed in recent decades for the treatment of non-small cell lung cancer (NSCLC). Although trials have shown this procedure to be safe and feasible a VATS approach for lobectomy has not been widely used yet. Surgeons can go beyond this limit by following a specific operative plan focused on learning the minimally invasive technique in centers of excellence and then including: a pre-operative phase based on the radioclinical assessments and an operating phase designed to develop a methodical approach to VATS technique...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078641/robotic-assisted-lobectomy-for-locally-advanced-lung-cancer
#18
REVIEW
Giulia Veronesi, Pierluigi Novellis, Orazio Difrancesco, Mark Dylewski
Some series report the use of video-assisted thoracic surgery (VATS) in patients with locally advanced non-small cell lung cancer (NSCLC) but, few studies describe the use of the robotic approach specifically for locally advanced disease. One potential advantage of the robotic approach over traditional VATS is the increased radicality. While the benefit of the robotic approach over open thoracotomy is directly related to reduced surgical trauma and the improved tolerability in fragile patients that have received induction treatment...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078624/the-role-of-wet-lab-in-thoracic-surgery
#19
REVIEW
Benedetta Bedetti, Philipp Schnorr, Joachim Schmidt, Marco Scarci
During the last three decades, minimally invasive surgery has become common practice in all kinds of surgical disciplines and, in Thoracic Surgery, the minimally invasive approach is recommended as the treatment of choice for early-stage non-small cell lung cancer. Nevertheless, all over the world a large number of lobectomies is still performed by conventional open thoracotomy and not as video-assisted thoracic surgery (VATS), which shows the need of a proper training for this technique. Development and improvement of surgical skills are not only challenging and time-consuming components of the training curriculum for resident or fellow surgeons, but also for more experienced consultants learning new techniques...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078623/uniportal-video-assisted-thoracoscopic-surgery-argentinian-experience
#20
Gustavo Bondulich, Diego Gonzalez Rivas
The acceptance of uniportal video-assisted thoracoscopic surgery (VATS) for minor and major thoracic procedures is growing in South America. This study presents the experience with uniportal VATS in Buenos Aires, Argentina. In a retrospective study, 181 patients were operated with uniportal VATS technique between December 2013 and October 2016. Uniportal procedures included minor and major procedures. Uniportal VATS were analyzed en terms of morbidity, mortality, conversion rate, hospital stay. A total of 181 patients were analyzed...
2017: Journal of Visualized Surgery
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