Uniportal Video-Assisted Thoracoscopic Surgery (VATS) Pulmonary Wedge Resection Assisted with Magnetic Anchor Technique: A Preliminary Experiment Study

2020 ◽  
Vol 231 (4) ◽  
pp. e218
Author(s):  
Yixing Li ◽  
Yi Lin ◽  
Yong Zhang ◽  
Yi Lyu ◽  
Xiaopeng Yan
Keyword(s):  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Experiment Study ◽  
Video Assisted ◽  
Pulmonary Wedge Resection ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Is tubeless uniportal video-assisted thoracic surgery for pulmonary wedge resection a safe procedure?

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i70-i76 ◽  
Author(s):  
Chao-Yu Liu ◽  
Po-Kuei Hsu ◽  
Ka-I Leong ◽  
Chien-Kun Ting ◽  
Mei-Yung Tsou
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Chest Drain ◽  
Safe Procedure ◽  
X Rays ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Clinically Significant ◽  
Pulmonary Wedge Resection

Abstract OBJECTIVES Tubeless uniportal video-assisted thoracic surgery (VATS), using a uniportal approach and non-intubated anaesthesia while avoiding postoperative chest drain insertion, for patients undergoing thoracoscopic surgery has been demonstrated to be feasible in selected cases. However, to date, the safety of the procedure has not been studied. METHODS We reviewed consecutive patients undergoing non-intubated uniportal VATS for pulmonary wedge resection at 2 medical centres between August 2016 and October 2019. The decision to avoid chest drain insertion was made in selected candidates. For those candidates in whom a tubeless procedure was performed, postoperative chest X-rays (CXRs) were taken on the day of the surgery [operation (OP) day], on postoperative day 1 and 1–2 weeks later. The factors associated with abnormal CXR findings were studied. RESULTS Among 135 attempts to avoid chest drain insertion, 13 (9.6%) patients ultimately required a postoperative chest drain. Among 122 patients in which a tubeless procedure was performed, 26 (21.3%) and 47 (38.5%) had abnormal CXR findings on OP day and postoperative day 1, respectively. Among them, 3 (2.5%) patients developed clinically significant abnormal CXRs and required intercostal drainage. Primary spontaneous pneumothorax was independently associated with a higher risk of postoperative abnormal CXRs. CONCLUSIONS Tubeless uniportal VATS for pulmonary wedge resection can be safely performed in selected patients. Most patients with postoperative abnormal CXRs presented subclinical symptoms that spontaneously resolved; only 2.5% of patients with postoperative abnormal CXRs required drainage.

scholarly journals Thoracic Paravertebral Block with Adjuvant Dexmedetomidine in Video-Assisted Thoracoscopic Surgery: A Randomized, Double-Blind Study

2019 ◽  
Vol 8 (3) ◽  
pp. 352 ◽  
Author(s):  
Boohwi Hong ◽  
ChaeSeong Lim ◽  
Hyemin Kang ◽  
Hongsik Eom ◽  
Yeojung Kim ◽  
...  
Keyword(s):  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Paravertebral Block ◽  
P Value ◽  
Double Blind Study ◽  
Thoracic Paravertebral Block ◽  
Video Assisted ◽  
Fentanyl Consumption ◽  
Video Assisted Thoracoscopic Surgery

Background: The addition of the adjuvant dexmedetomidine to a nerve block improves the quality of the block and reduces perioperative opioid consumption. The aim of this study was to assess the effect of dexmedetomidine as an adjuvant for the thoracic paravertebral block (TPVB) in postoperative pain control after video-assisted thoracoscopic surgery (VATS). Methods: Sixty-six males, aged 15–40 years, with spontaneous pneumothorax scheduled for VATS wedge resection were enrolled. Following surgery, ultrasound-guided TPVB was performed on the T3 and T5 levels with 30 mL of 0.5% ropivacaine, plus adjuvant dexmedetomidine 50 μg or normal saline. The primary outcome was cumulative fentanyl consumption at 24 h. Pain severity, the requirement for additional rescue analgesics, hemodynamic variations, and side effects were also evaluated. Results: Median postoperative cumulative fentanyl consumption at 24 h was significantly lower in the dexmedetomidine group (122.6 (interquartile range (IQR) 94.5–268.0) μg vs. 348.1 (IQR, 192.8–459.2) μg, p-value = 0.001) with a Hodges–Lehman median difference between groups of 86.2 (95% confidence interval (CI), 4.2–156.4) mg. Coughing numeric rating scale (NRS) was lower in the dexmedetomidine group at postoperative 2, 4, 8, and 24 h. However, resting NRS differed significantly only after 4 h postoperative. Conclusions: Dexmedetomidine as an adjunct in TPVB provided effective pain relief and significantly reduced opioid requirement in VATS.

scholarly journals Robotic video-assisted thoracoscopic surgery using conventional thoracoscopic access

2020 ◽  
Vol 28 ◽  
pp. 93-100
Author(s):  
Vu Huu Vinh ◽  
Dang Dinh Minh Thanh ◽  
Nguyen Viet Dang Quang ◽  
Truong Cao Nguyen
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Operation Time ◽  
Tumour Resection ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Tube Removal ◽  
Conventional Open Surgery ◽  
Video Assisted Thoracoscopic Surgery

Video assisted thoracic surgery (VATS) has been widely used and confirmed to be effective and less invasive compared with conventional open surgery. Robotic video-assisted thoracic surgery (R-VATS) is VATSusing a surgeon-controlled robotic system. R-VATS has been increasingly performed worldwide but not in Vietnam. Wehave started implementing r-VATS since July 2018, using conventional thoracoscopic accesses (trocars) and reported our initial results after 18 months of implementation with 116 cases. 57 cases of lobectomy, 9 cases of wedge resection,19 cases of thymectomy, 28 cases of mediastinal tumour resection, 1 case of esophagectomy, 1 case of oesophageal leiomyoma resection, and 1 case of diaphragm plication. 110 cases had good outcomes with no complications, 5 cases suffered from haemothorax that lasted for more than 5 days. Onepatient died after 35 days due to pneumonia. The operation time was comparable to that ofc- VATS. Average time to chest tube removal was 2 days. Time from surgery to discharge was comparable to that ofc-VATS.

scholarly journals Continuous surgical multi-level extrapleural block for video-assisted thoracoscopic surgery: a retrospective study assessing its efficacy as pain relief following lobectomy and wedge resection

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1783 ◽  
Author(s):  
Mark Larsson ◽  
Anders Öwall ◽  
Ulrik Sartipy ◽  
Anders Franco-Cereceda ◽  
Barbro Johansson ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Vats Lobectomy ◽  
Video Assisted ◽  
Analgesic Regimen ◽  
Multi Level ◽  
Pain At Rest ◽  
Video Assisted Thoracoscopic Surgery

Background: Video-assisted thoracoscopic surgery (VATS) causes less postoperative pain than thoracotomy; however, adequate analgesia remains vital. As part of a multi-modal postoperative analgesia, a continuous surgeon-placed extrapleural block catheter is an option. The aim of this retrospective study was to evaluate the analgesic efficacy of a continuous extrapleural block as part of a multimodal analgesic regimen after VATS in general, and VATS lobectomy and wedge resection in particular. Methods: Case records for patients having undergone VATS surgery and been provided a multi-level continuous extrapleural block with an elastomeric pump infusing levobupivacaine 2.7 mg/ml at a rate of 5 ml/h during 2015 and 2016 were reviewed. Pain (Numeric Rating Scale) at rest and mobilisation as well as opioid requirement (daily, postoperative days 0-3, as well as accumulated) were analysed.    Results: In all, 454 records were reviewed: 150 wedge resections, 264 lobectomies and 40 miscellaneous cases. At rest, pain was mild median NRS rated 3-3-1-1 for postoperative day (POD) 0 to 3, during movement, pain was rated moderate during POD 0 and 1 and mild the remaining days (median NRS 4-4-3-3 for POD 0-3). The proportion of patients exhibiting mild pain at rest increased from 55% on POD 0 to 81 % on POD 3. The percentage of patients experiencing severe pain at rest decreased from 15% to 6%. Median oxycodone consumption was 10 mg per day for POD 1-3. Pain after VATS wedge resection was significantly lower at POD 1 and 3 compared to pain after VATS lobectomy. Conclusion: We found a continuous surgeon-placed extrapleural catheter block to be a valuable and seemingly safe addition to our multimodal procedure specific analgesia after VATS. Whether the efficacy of the block can be improved by increasing local anaesthetic and/or adding adjuncts warrants further investigation.

Subxiphoid Video-Assisted Thoracoscopic Surgery for Lung Resection Under Spontaneous Ventilation: Case Report

2021 ◽  
Vol 104 (11) ◽  
pp. 1847-1849
Keyword(s):  
Case Report ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Foley Catheter ◽  
Spontaneous Ventilation ◽  
Chest Drain ◽  
Arterial Line ◽  
Video Assisted ◽  
Subxiphoid Approach ◽  
Video Assisted Thoracoscopic Surgery

This case report describes two patients that underwent successful video-assisted thoracoscopic surgery (VATS) lung resections under spontaneous ventilation using the uniportal subxiphoid approach. The authors performed lung wedge resection in both patients under local anesthesia without using of a Foley catheter, arterial line, or intercostal chest drain. Only intravenous drugs and an oxygen mask with reservoir bag were used. The postsurgical course for both patients was uneventful. Both were discharged on postoperative day 2 and were doing well at 1- and 3-month follow-ups. Keywords: Subxiphoid approach; Pulmonary resection; Lung cancer

Video-Assisted Thoracic Surgery

2016 ◽  
Author(s):  
Scott J. Swanson ◽  
Abby White
Keyword(s):  
Thoracic Surgery ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Wedge Resection ◽  
Hospital Length Of Stay ◽  
Port Placement ◽  
Video Assisted ◽  
Trocar Placement ◽  
Video Assisted Thoracoscopic Surgery

Since the early 1990s, video-assisted thoracoscopic surgery (VATS) has revolutionized surgical care. The era of VATS is sufficiently mature that enough data have accrued to compare the efficacy of VATS with that of open procedures. In this regard, anatomic pulmonary resection by VATS has led to significant reductions in morbidity, mortality, and hospital length of stay, allowing patients a more expeditious return to regular activities. VATS has been used in the treatment of both benign and malignant diseases of the chest. Furthermore, VATS may be used in selected patients with early-stage lung cancer without breaching oncologic surgical principles. This review covers the case for VATS technology; operative planning; basic thoracoscopy operative technique; VATS procedures for pleural disease, pulmonary wedge resection, spontaneous pneumothorax and bullous disease, lung volume reduction surgery, lobectomy, mediastinal lymph node dissection, pericardial window, mediastinal masses, management of thoracic trauma, sympathectomy and splanchnicectomy; and cost considerations. Figures show preoperative evaluation; proper patient position in the operating room, with the patient propped on pontoons; triangulation technique for port placement in relation to intrathoracic structures and targets; thoracoscope and trocar placement; video and monitors; wedge resection with lung compression clamp; tissue-reinforced stapler  inserted into the chest; endoleader looped around the superior pulmonary vein; endoleader looped around the truncus anterior and its branch; and division of the upper lobe bronchus. Tables list indications and relative contraindications for VATS procedures, basic instruments and equipment used for VATS procedures, and operative steps for VATS lobectomy.   This review contains 10 highly rendered figures, 3 tables, and 35 references Key words: Video-assisted thoracoscopic surgery; VATS; Minimally invasive thoracic surgery; Thoracoscopy; Rigid thoracoscope; Flexible thoracoscope; Thoracoport

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