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Uniport vats

Jia-Ming Chang, Kam-Hong Kam, Yi-Ting Yen, Wei-Li Huang, Wei Chen, Yau-Lin Tseng, Ming-Ho Wu, Wu-Wei Lai, Diego Gonzalez-Rivas
Our study sought to review our experience from biportal to uniportal video-assisted thoracoscopic surgery (VATS) major lung resection. Lessons we learned from the evolution regarding technical aspects were also discussed.We retrospectively reviewed patients who underwent VATS lobectomy or segmentectomies in Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan, during January 2012 and December 2014. Patient clinical profiles, surgical indications and procedures, postoperative course, and oncological parameters were analyzed and compared between the biportal and uniportal groups...
October 2016: Medicine (Baltimore)
Diego Gonzalez-Rivas, Jessica Correa Marin, Juan Pablo Ovalle Granados, Juan David Urrea Llano, Sonia Roque Cañas, Alonso Oviedo Arqueta, Mercedes de la Torre
Tracheobronchial pediatric tumors are very rare and procedures like pneumonectomy are seldomly indicated due to the associated morbidity. If a surgical approach is considered, the ideal oncological technique would be the minimally invasive sleeve resection, allowing preservation of lung parenchyma (very important in pediatric patients). Here we present the first report of a thoracoscopic right upper tracheo-bronchial sleeve lobectomy in a pediatric patient. A 10-year-old female patient, who received multiple antibiotic treatments for recurrent pneumonia without improvement, was diagnosed with a right upper lobe (RUL) carcinoid tumor...
September 2016: Journal of Thoracic Disease
Huan H Sun, Joanna Sesti, Jessica S Donington
Recent advances in the surgical treatment of early stage non-small cell lung cancer (NSCLC) have focused heavily on making procedures less invasive, less radical, and better tolerated. Advances in accuracy and increased utilization of cross-sectional imaging allows for diagnosis of smaller and more indolent tumors and preinvasive lesions. Similar to advanced disease, early-stage treatment is now being tailored to individual patients and their tumors. Sublobar resections are gaining acceptance as an oncologically equivalent approach to lobectomy in well-selected stage I patients...
October 2016: Seminars in Respiratory and Critical Care Medicine
József Furák, Balázs Pécsy, Aurél Ottlakán, Tibor Németh, Tibor Géczi, László Tiszlavicz, Anna Lakatos, György Lázár
OBJECTIVES: Herein we present the results of lobectomies performed with minimally invasive approach (video-assisted thoracic surgery - VATS) at our department during a period of five years. METHODS: Between 1 January 2011 and 31 December 2015, 197 lobectomies (malignant lesions: 176 cases, benign lesions: 21 cases) were performed by three thoracic surgeons and one resident. Demographical data are as follows: 119 female/78 male, mean age: 62.4 years (range: 41-82 years)...
September 2016: Magyar Sebészet
Tom Treasure, Paul De Leyn
Third Mediterranean Symposium on Thoracic Surgical Oncology, Catania, Italy, 21-22 April 2016 The primary justification for mediastinal lymphadenectomy is that it provides more complete nodal staging to help select best adjuvant treatments. There is a secondary argument that dissection of nodes might remove otherwise unrecognized nodal disease to increase the chance of cure. They have to be thought through again as patients look for less invasive treatments for their cancers such as videothoracoscopy and stereotactic radiotherapy...
September 19, 2016: Future Oncology
Mingxiang Feng, Miao Lin, Yaxin Shen, Hao Wang
A 62-year-old female was admitted to our hospital after computed tomography (CT) revealed a 2.5 cm × 2.1 cm mass in the left upper lobe. PET/CT scan diagnosed as malignant lesion with no signs of metastasis. Under general anesthesia, the patient was placed in right lateral decubitus position. A 4cm incision was made in the 4th intercostal space with plastic protector. The camera was placed in the upper part of the incision and the instruments were inserted below the camera. Left upper lobectomy along with systematic lymphadenectomy was performed...
August 2016: Journal of Thoracic Disease
Gang Shen, Ying Chai, Lijian Huang, Maoying Yang, Guofei Zhang
Over the past decade, uniportal video-assisted thoracic surgery (VATS) has been reported to be a promising, less invasive alternative with potentially better cosmesis and less postoperative pain and paraesthesia. Although uniportal VATS has now evolved into a sophisticated technique capable of performing some of the most complex thoracic procedures, this approach to lobectomy is not standardized, and the surgical procedure still varies between surgeons. Here, we describe our uniportal VATS procedure during right upper lobectomy in a patient with a nodule in the right upper lobe...
August 2016: Journal of Thoracic Disease
Ding-Pei Han, Jie Xiang, He-Cheng Li, Jun-Biao Hang
This video demonstrated a performance of uniportal video-assisted thoracoscopic surgery (VATS) right upper lobectomy with systemic lymphadenectomy. The patient had a malignant mass in his right upper lobe. The operator took a posterior to anterior approach to dissection the right upper lobe, the adjacent structures were clearly demonstrated after the entire dissection of mediastinal lymph nodes. Postoperative pathological report suggested the stage of the tumor was T1bN0M0 (stage IA).
August 2016: Journal of Thoracic Disease
Qi Wang, Yi-Xin Cai, Yu Deng, Sheng-Ling Fu, Xiang-Ning Fu, Ni Zhang
Uniportal video-assisted thoracoscopic lobectomy for non-small-cell lung cancer is accepted worldwide, with incisions ranging from 4 to 6 cm. We believed in less invasive and more precise that uniportal video-assisted thoracoscopic lobectomy could be. Therefore, we performed modular uniportal thoracoscopic lobectomy with systemic lymphadenectomy on left upper lobe using a 3-cm-diameter port. And the modular surgical route was arranged in seven modules. Anesthesia, patient positioning and instruments play an important role in the surgery...
August 2016: Journal of Thoracic Disease
Jun-Qiang Fan, Jie Yao, Zhi-Bo Chang, Qi Wang
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...
August 2016: Journal of Thoracic Disease
Zongwu Lin, Junjie Xi, Songtao Xu, Qun Wang
A 63-year-old male was referred to our hospital with two existing lesions in bilateral lungs. Computed tomography (CT) showed a 15-mm ground-glass opacity (GGO) in the superior segment of left lower lung (S6) and a 5-mm GGO in the center of the right upper lobe. The preoperative clinical diagnosis was stage I primary lung cancer for the left lesion while the right lesion needed follow-up. Uniportal video-assisted thoracic surgery (VATS) left superior segmentectomy in the semiprone position was performed in this case and the right upper lobe was kept untouched...
August 2016: Journal of Thoracic Disease
Simon C Y Chow, Calvin S H Ng
In the modern era when screening and early surveillance of pulmonary nodules is increasing in importance, the management of the pulmonary nodule represents a different challenge to thoracic surgeons. The difficulty lies in the merging of sound surgical and oncological principles with more minimally invasive and appropriate lung sparing surgery. Furthermore, the intra-operative identification and surgical management of small and sometimes multi-focal pulmonary lesions remain challenging. There have been many developments and innovations in the field of video-assisted thoracoscopic surgery (VATS) to cater for the demands from increasing incidence of pulmonary nodules with associated paradigm shift in their surgical management...
July 2016: Journal of Thoracic Disease
Xiaogang Zhao, Gening Jiang, Chang Chen, Chenyang Dai, Yuming Zhu
Although uniportal video-assisted thoracoscopic surgery (UVATS) is associated with decreased pain and chest wall paresthesia, as well as better cosmesis, it has not been widely accepted by thoracic surgeons. This lack of acceptance is largely because instrument collisions are difficult to avoid when many instruments are crowded into a single incision. We designed a set of instruments, including a clamp with a string and a U-shaped direction converter for lung traction, to provide better exposure during UVATS for lobectomy without the need for an endograsper...
September 2016: Annals of Thoracic Surgery
Moana Rossella Nespoli, Marco Rispoli, Dario Maria Mattiacci, Marianna Esposito, Antonio Corcione, Carlo Curcio, Salvatore Buono
INTRODUCTION: We present the case of a patient with dilatative cardiomyopathy waiting for heart transplantation with pleural effusion to be subjected to pleural biopsy, treated with preoperative infusion of levosimendan to improve heart performances. PRESENTATION OF CASE: A 56-year-old man (BMI 22,49) with dilatative cardiomyopathy (EF 18%) presented right pleural effusion. The levosimendan treatment protocol consisted of 24h continuous infusion (0,1ug/kg/min), without bolus...
2016: International Journal of Surgery Case Reports
Zhe Shi, Chang Chen, Sen Jiang, Gening Jiang
Although uniportal video-assisted thoracic surgery (VATS) is becoming more popular, it's still very challenging to conduct a wedge resection of small pulmonary ground-glass opacities (GGOs), especially deeply situated subpleural GGOs, via uniportal VATS. We successfully performed thirteen uniportal VATS wedge resections through an approach that combines radiologically guided microcoil localization with palpation, and we encountered no complications related to the new approach. Based on our experience, a combination of CT-guided microcoil localization with palpation in uniportal VATS for deeply situated subpleural GGOs is a safe and effective procedure for accurate diag¬nosis and resection of indeterminate GGOs...
July 2016: Journal of Thoracic Disease
Luis Angel Hernandez-Arenas, Lei Lin, Yang Yang, Ming Liu, William Guido, Diego Gonzalez-Rivas, Gening Jiang, Lei Jiang
OBJECTIVES: Uniportal subxiphoid video-assisted thoracoscopic (SVATS) surgery for major lung resections is a new approach, but clinical evidence is lacking. The aim of this study was to examine our experience with the use of the uniportal subxiphoid approach in video-assisted thoracoscopic (VATS) major lung resections and lymph node dissections. METHODS: From October 2014 to August 2015, 153 patients with early-stage non-small-cell lung carcinoma (NSCLC) and benign disease underwent uniportal subxiphoid VATS major lung resections...
July 11, 2016: European Journal of Cardio-thoracic Surgery
Andrea Droghetti, Jacopo Vannucci, Antonello Bufalari, Guido Bellezza, Valentina De Monte, Giuseppe Marulli, Maria Caterina Bottoli, Michele Giovanardi, Niccolò Daddi, Verena De Angelis, Franco Moriconi, Francesco Puma
Sclerosing fluids to achieve pleurodesis could be hardly replaced for bed-side procedures, but other devices may be successfully applied during thoracoscopy. Thulium Cyber Laser was experimented for this purpose and compared to talc poudrage. Twenty pigs underwent operative videothoracoscopy (VATS). Ten models were subjected to double-port VATS and parietal pleura photoevaporation using Thulium Cyber Laser™ (TCL) 150 W 2010 nm on the posterior third of three ribs; the pleural surface was homogeneously treated inside the target perimeter...
September 2016: Lasers in Medical Science
Yu Deng, Zhipeng Hao, Xiangning Fu
Uniportal video-assisted thoracic surgery (Uni-VATS) has become one of the most exciting new developments in minimally invasive thoracic surgery in recent 5 years. With the development of better thoracoscopic cameras and the availability of endoscopic linear mechanical staplers, experts in the technique are able to use uniportal VATS to encompass the most complex procedures such as bronchial sleeve/vascular reconstructions or carinal resections. A large number of multi-center reports have confirmed that Uni-VATS lobectomy is safe and feasible; dissected node group number and total number of mediastinal lymph nodes were not less than that of traditional muli VATS; Uni-VATS gained positive results in pain, trauma and recovery time...
June 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Yang Yang, William Guido Guerrero, Iskander Algitmi, Diego Gonzalez-Rivas
The uniportal approach for major pulmonary resections began in 2010 with the first case being performed by González-Rivas and colleagues in La Coruña. Since then a number of teams around the world had being performing hundreds of cases, applying it to more advance and complex cases recently. The technique has been reported to be feasible and reliable with similar results to that obtained in early stage lung cancer lobectomies. The case presented in this article is an example of an extreme condition: very obese patient, strong adhesions, fused lower lobe to the diaphragm and enlarged inflammatory adenopathies that made the procedure very technically challenging...
June 2016: Journal of Thoracic Disease
Ching-Feng Wu, Ming-Ju Hsieh, Hung-Pin Liu, Diego Gonzalez-Rivas, Yun-Hen Liu, Yi-Cheng Wu, Yin-Kai Chao, Ching-Yang Wu
BACKGROUND: The establishment of a golden standard for post-operative analgesia after thoracic surgery remains an unresolved issue. Benefiting from the rapid development of single port video-assisted thoracoscopic surgery (VATS), a good candidate for the alleviation of patients' pain is the placement of an intercostal catheter (ICC) safely after uniport VATS. We hypothesized that continual infusion through ICC could provide effective analgesia for patients with only one wound and we evaluate its postoperative analgesic function in uniport VATS patients with or without intercostal nerve blockade...
June 2016: Journal of Thoracic Disease
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