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Techniques of lung lobectomy

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https://www.readbyqxmd.com/read/29136038/midterm-outcomes-of-single-port-thoracoscopic-surgery-for-major-pulmonary-resection
#1
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
#2
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
#3
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: J Vis Surg
https://www.readbyqxmd.com/read/29078692/robotic-lobectomy
#4
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: J Vis Surg
https://www.readbyqxmd.com/read/29078686/uniportal-video-assisted-thoracoscopic-surgery-in-hemothorax
#5
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: J Vis Surg
https://www.readbyqxmd.com/read/29078677/uniportal-video-assisted-thoracoscopic-surgery-vats-technique-is-associated-with-decreased-narcotic-usage-over-traditional-vats-lobectomy
#6
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: J Vis Surg
https://www.readbyqxmd.com/read/29078672/robotic-lobectomies-when-and-why
#7
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: J Vis Surg
https://www.readbyqxmd.com/read/29078665/steps-in-the-development-of-a-vats-lobectomy-program
#8
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: J Vis Surg
https://www.readbyqxmd.com/read/29078641/robotic-assisted-lobectomy-for-locally-advanced-lung-cancer
#9
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: J Vis Surg
https://www.readbyqxmd.com/read/29078624/the-role-of-wet-lab-in-thoracic-surgery
#10
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: J Vis Surg
https://www.readbyqxmd.com/read/29078623/uniportal-video-assisted-thoracoscopic-surgery-argentinian-experience
#11
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: J Vis Surg
https://www.readbyqxmd.com/read/29078614/intra-pericardial-double-sleeve-uniportal-video-assisted-thoracoscopic-surgery-left-upper-lobectomy
#12
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: J Vis Surg
https://www.readbyqxmd.com/read/29078604/video-assisted-thoracoscopic-surgery-bronchial-sleeve-lobectomy
#13
REVIEW
Fabio Davoli, Luca Bertolaccini, Alessandro Pardolesi, Piergiorgio Solli
A sleeve lobectomy (SL) is considered a valid option instead of a pneumonectomy in patients affected by central non-small cell lung cancer (NSCLC). In the last few years, the improvement of video-assisted thoracoscopic surgery (VATS) has allowed experienced surgeons to carry out this challenging operation by a minimally invasive approach. A full pre-operative assessment enclosing a flexible fiber-optic bronchoscopy evaluation and a multidisciplinary team discussion of the clinical case must be accomplished...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078597/teaching-video-assisted-thoracic-surgery-lobectomy-using-an-ex-vivo-simulation-model
#14
Marcelo Jimenez, Maria Teresa Gomez-Hernandez
Video-assisted thoracic surgery (VATS) is gradually replacing conventional open thoracotomy as the standard approach of many lung resections and thoracic surgical trainees and experienced surgeons must learn and master this technique. Simulation based training may be a good option to acquire or improve these advanced skills, however realistic and inexpensive simulators are not accessible or commercially available. We developed a low cost and hi fidelity simulation model using porcine heart-lung blocks.
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078595/technique-of-video-assisted-thoracoscopic-left-pneumonectomy
#15
Mark W Hennon, Todd L Demmy
Video-assisted thoracoscopic surgery (VATS) approaches to lobectomy for treatment of early stage non-small cell lung cancer (NSCLC) have generally been accepted to be beneficial. Experience and results for more extensive resections, including thoracoscopic pneumonectomy are limited. Here we report a case with attached videos describing key technical aspects of performing a thoracoscopic left pneumonectomy. This demonstrates the adoption of VATS for tumor pathology requiring pneumonectomy is feasible and can be done safely...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078587/subxiphoid-uniportal-lobectomy
#16
Mohamed M Moneer ElSaegh, Nur Aziah Ismail, Mohamed I Mydin, Marco Nardini, Joel Dunning
Video-assisted thoracic surgery (VATS) surgery has seen an evolution from multiple ports to uniportal and finally subxiphoid uniportal recently. In traditional VATS surgery, the instruments and the thoracoscope enter the thoracic cavity through two to four operating ports on the lateral chest wall, which can cause chronic pain and chest wall numbness. However single-portal VATS surgery could potentially cause similar problems as the port is placed in between the ribs. In March 2015 Liu et al. reported a VATS bilateral pulmonary metastasectomy and right middle lobectomy via a subxiphoid uniportal technique...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078584/anatomical-video-assisted-thoracoscopic-surgery-segmentectomies-based-on-the-three-dimensional-reformation-images
#17
Qianli Ma, Tong Bao, Haitao Zhang, Chaoyang Liang, Deruo Liu
Segmentectomy was first done in 1939 by Churchill and Belsey in 1939. Video-assisted thoracoscopic surgery (VATS) segmentectomies are still more technically challenging than VATS lobectomies. With the increasing rate of early stage lung carcinomas, the thoracoscopic segmentectomies may have a major role in a near future. Four anatomical VATS segmentectomy videos clips were shared in this study. CT three-dimensional reformation could exactly show the small pulmonary nodule's precise position, clarifies the surrounding structures' relationship like the pulmonary artery (PA), pulmonary vein (PV), bronchus (B), fissure, and lymph nodes...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078573/nonintubated-video-assisted-thoracic-surgery-lobectomy-for-lung-cancer
#18
Ming-Hui Hung, Shun-Mao Yang, Jin-Shing Chen
Nonintubated video-assisted thoracic surgery (VATS) is now well established and is performed in different institutions as a safe and versatile procedure in selected patients. To share the surgical and anesthetic techniques for nonintubated VATS, we present a 56-year-old female patient who underwent nonintubated VATS left upper lobectomy for primary non-small cell lung cancer. Our patient was sedated in a spontaneous breathing status using a target-controlled infusion of propofol. Additionally, regional anesthesia using intercostal block and left-sided intrathoracic vagal block enabled us to do left upper lobectomy and mediastinal lymph node dissection without difficulty...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29039137/three-dimensional-image-in-lung-transplantation
#19
Toyofumi F Chen-Yoshikawa, Hiroshi Date
Three-dimensional computed tomography (3D-CT) technologies have been developed and, recently, high-speed and high-quality 3D-CT technologies have been introduced to the field of thoracic surgery. The purpose of this manuscript is to demonstrate the clinical application of 3D-CT technologies in lung transplantation. In Japan, because of the severe donor shortage, living-donor lobar lung transplantation (LDLLT) is essential, in addition to cadaveric lung transplantation. In LDLLT, size matching is a grave issue, since ideal size matching between donor and recipient is usually difficult because of the limited population of potential donor...
October 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29038404/-treatment-policy-for-avoiding-pneumonectomy-regarding-the-locally-advanced-lung-cancers
#20
Noriyuki Takahashi
The problem of pneumonectomy may result from an elimination of the extensive pulmonary vascular bed as a unit. Therefore this paper has indicated that 10 cases with the locally advanced lung cancers had been treated with some parenchymal sparing procedures including chemotherapy in order to avoid pneumonectomy. Six cases with preoperative chemotherapy were performed sleeve lobectomy in 3 cases, tangential pulmonary artery(PA) resection in 2, and left atrium partial resection in 1. One case with irradiation in vain was done sleeve LLL+lS4+5segmentectomy...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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