Real-time monitoring of a video-assisted thoracoscopic surgery lobectomy programme using a specific cardiopulmonary complications risk-adjusted control chart

Abstract INTRODUCTION The adoption of surgical planning systems could greatly simplify the performance of video-assisted thoracoscopic surgery and improve its safety. MATERIAL AND METHODS A new application for surgical planning in video-assisted thoracoscopic surgery was developed, making use of the HoloLens (v1) mixed reality device. The information was displayed in the form of interactive holograms, by means of gestural, visual or voice control. The application was validated during a video-assisted right upper lobectomy surgery, including systematic lymphadenectomy for squamous cell carcinoma in the right upper lobe. RESULTS No complications were shown during surgery. Prior to surgery, the system allowed the surgeon to access in real time the patient's medical history, review the computed tomography study, and visualize and manipulate a 3D model of the lung with its respective vascular and bronchial elements, as well as the tumor to be removed. The surgeon’s vision using the device was easily shared with the rest of the surgical team. The surgeon placed the holographic models with the surgical planning information behind the field of view of the operating table for possible reference during the procedure. The weight and heat generated by the device were considered ergonomic aspects to be improved. CONCLUSIONS The system provides real-time access to important patient information for surgical planning during video-assisted lobectomy surgery, without losing the sterility of the surgical act. The surgeon's view can be shared for communication and learning purposes, as well as recorded for later review of surgical complications.

Download Full-text

Video-assisted thoracoscopic surgery in local anaesthesia and analgosedation – a survey among the members of the German Society of Thoracic Surgeons

10.1055/s-0039-1694112 ◽

2019 ◽

Author(s):

T Galetin ◽

A Lopez-Pastorini ◽

E Stoelben

Keyword(s):

Local Anaesthesia ◽

Thoracoscopic Surgery ◽

German Society ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

Download Full-text

Myasthenia gravis miatt végzett három különböző típusú csecsemőmirigy-eltávolítás sebészeti és korai neurológiai eredményei

Magyar Sebészet (Hungarian Journal of Surgery) ◽

10.1556/1046.68.2015.6.1 ◽

2015 ◽

Vol 68 (6) ◽

pp. 219-224

Author(s):

Aurél Ottlakán ◽

Tibor Géczi ◽

Balázs Pécsy ◽

Bernadett Borda ◽

Judit Lantos ◽

...

Keyword(s):

Myasthenia Gravis ◽

Thoracoscopic Surgery ◽

Extended Thymectomy ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

Absztrakt Célkitűzés: A myasthenia gravis (MG) kezelésében számos nyitott, illetve minimálisan invazív thymectomia ismert. A tanulmány ugyanazon intézeten belül a transsternalis (TS), illetve kétféle minimálisan invazív thymectomia (video-assisted thoracoscopic extended thymectomy – VATET; unilateral video-assisted thoracoscopic surgery – UL-VATS) eredményeit hasonlítja össze. Anyag és módszerek: Három különböző időintervallumban 71 betegnél történt thymectomia MG miatt (60 nő, 11 férfi): 23 transsternalis thymectomia (1995. január–2004. szeptember), 22 VATET (2004. szeptember – 2009. augusztus) és 26 UL-VATS thymectomia (2009. szeptember – 2011. december). Az eredmények értékelésénél a műtéti idő, MG-hez társuló neurológiai és a műtét utáni sebészi szövődmények, valamint az MG státuszában az egyéves utánkövetéskor észlelt neurológiai változások szerepeltek. Eredmények: Perioperatív mortalitás nem fordult elő. A műtéti idő 112, 211, 116 perc (p = 0,001), a kórházi napok száma: 8,9, 5,6 és 4 nap (p = 0,001) volt a TS-, VATET- és UL-VATS-csoportban. Az MG-hez kapcsolódó postoperativ neurológiai szövődmények 21,7%, 18,2% és 7,7% (p = 0,365) értékeket mutattak. A sebészi szövődmény 4,3%, 13,7%, 0% (p = 0,118) volt. Az MG tüneteinek javulása 91,3%, 94,7%, 87,5% (p = 0,712), míg komplett remisszió 13%, 10,5%, 11,5% (p = 0,917) volt a TS-, VATET- és UL-VATS-csoportokban. Következtetések: A műtéti idő, valamint a kórházban eltöltött napok száma UL-VATS esetében volt a legrövidebb. A kisebb sebészi beavatkozáshoz alacsonyabb sebészi, illetve MG-s neurológiai szövődmények társultak. Az MG-tünetek javulásában mindhárom módszernél kiváló eredményt értek el.

Download Full-text

Nonintubated Uniportal Thoracoscopic Thymectomy with Laryngeal Mask

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0039-1696950 ◽

2019 ◽

Vol 68 (05) ◽

pp. 450-456 ◽

Cited By ~ 1

Author(s):

Zhengcheng Liu ◽

Rusong Yang ◽

Yang Sun

Keyword(s):

Thoracoscopic Surgery ◽

Anterior Mediastinum ◽

Laryngeal Mask ◽

Double Lumen Tube ◽

Perioperative Outcomes ◽

Video Assisted ◽

Incision Size ◽

The Mean ◽

End Tidal ◽

Video Assisted Thoracoscopic Surgery

Abstract Objective To investigate whether laryngeal mask anesthesia had more favorable postoperative outcomes than double-lumen tube intubation anesthesia in uniportal thoracoscopic thymectomy. Methods Data were collected retrospectively from December 2013 to December 2017. A total of 96 patients with anterior mediastinum mass underwent nonintubated uniportal video-assisted thoracoscopic thymectomy with laryngeal mask, and 129 patients underwent intubated uniportal video-assisted thoracoscopic thymectomy. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes between nonintubated uniportal video-assisted thoracoscopic surgery (NU-VATS) and intubated uniportal video-assisted thoracoscopic surgery (IU-VATS) were compared. Results In both groups, incision size was kept to a minimum, with a median of 3 cm, and complete thymectomy was performed in all patients. Mean operative time was 61 minutes. The mean lowest SpO2 during operation was not significantly different. However, the mean peak end-tidal carbon dioxide in the NU-VATS group was higher than in the IU-VATS group. Mean chest tube duration in NU-VATS group was 1.9 days. Mean postoperative hospital stay was 2.5 days, with a range of 1 to 4 days. Time to oral fluid intake in the NU-VATS group was significantly less than in the IU-VATS group (p < 0.01). Several complications were significantly less in the NU-VATS group than in the IU-VATS group, including sore throat, nausea, irritable cough, and urinary retention. Conclusion Compared with intubated approach, nonintubated uniportal thoracoscopic thymectomy with laryngeal mask is feasible for anterior mediastinum lesion, and patients recovered faster with less complications.

Download Full-text

Video-assisted thoracoscopic surgery in bronchogenic cysts of the esophagus

Journal of Clinical Gastroenterology ◽

10.1097/00004836-200609001-00079 ◽

2006 ◽

Vol 40 (Supplement 4) ◽

pp. S190

Author(s):

Ming-Jang Hsieh ◽

Sheung-Fat Ko ◽

Jui-Wei Lin ◽

Chung-Cheng Huang ◽

Chih-Chia Li ◽

...

Keyword(s):

Thoracoscopic Surgery ◽

Video Assisted ◽

Bronchogenic Cysts ◽

Video Assisted Thoracoscopic Surgery

Download Full-text

Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01432-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Deng ◽

Xiao-min Hou ◽

Xu-yan Zhou ◽

Qing-he Zhou

Keyword(s):

Rating Scale ◽

Numerical Rating Scale ◽

Thoracoscopic Surgery ◽

Controlled Trial ◽

Ultrasound Guided ◽

Video Assisted ◽

Prospective Randomized Controlled Trial ◽

Numerical Rating ◽

Intercostal Block ◽

Video Assisted Thoracoscopic Surgery

Abstract Background Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery. Methods Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups. Results The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons). Conclusion Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.

Download Full-text