Subxiphoid uniportal video‐assisted thoracoscopic surgery: A cosmetically superior approach to submammary rib tumor resection

Abstract Background Recent developments in robotic technology have brought significant changes in robotic video-assisted thoracoscopic surgery (r-VATS) worldwide, particularly including the treatment in the thorax for the mediastinal, esophagus, and pulmonary lesions. Currently, there are only a few reports describing the procedural experience and outcomes with r-VATS. The objective of this study is to provide our initial experience using r-VATS at a single center, with specific attention to safety, efficacy, and procedural details. Methods We retrospectively reviewed patients who underwent a newly modified r-VATS procedure for various surgical operations at the thoracic department of our hospital, from July 2018 to January 2020. Multiport trocars were placed in the classic triangular arrangement as in conventional VATS (c-VATS) but with modifications based on the type of surgery. The peri- and postoperative outcomes such as duration of surgery, complications, and duration of hospital stay for these patients were reported. Results Overall, 142 patients underwent r-VATS for lobectomy (66), wedge resection (15), thymectomy (22), mediastinal tumor resection (30), pneumonectomy (4), transthoracic esophagectomy (1), esophageal tumor resection or esophageal diverticulum repair (2), diaphragm plication (1), and mediastinal tumor resection plus thymectomy (1). For the entire cohort, the median operative time was 110 min, and the median length of hospital stay was 5 days. Conversion to open thoracic surgery was reported only in a total of 3 (2.1%) patients of pneumonectomy (1.4%) and mediastinal tumor resection (0.70%). All our patients were managed successfully with no postoperative complications and mortality. Conclusion Our method of r-VATS was found to be safe and effective and may be applied to different surgical operations. Adequate and proper training of thoracic surgeons is immediately needed for the transition from c-VATS to r-VATS. The utility and advantages of triangular trocar configuration for r-VATS require further refinement and research before it can be routinely adopted in clinical practice. Trial registration Retrospectively registered.

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Comparison of the perioperative outcomes in antero-superior mediastinal tumor resection performed by transcervical resection and video-assisted thoracoscopic surgery

Journal of Thoracic Disease ◽

10.21037/jtd.2018.11.114 ◽

2018 ◽

Vol 10 (12) ◽

pp. 6838-6845

Author(s):

Xin-Sheng Zhu ◽

Nan Song ◽

Nai-Cheng Song ◽

Alan Dart Loon Sihoe ◽

Wen-Xin He ◽

...

Keyword(s):

Mediastinal Tumor ◽

Thoracoscopic Surgery ◽

Tumor Resection ◽

Perioperative Outcomes ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery ◽

Transcervical Resection

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Transdiaphragmatic Single-Port Video-Assisted Thoracoscopic Surgery; a Novel Approach for Pulmonary Metastasectomy through Laparotomy Incision – Case Series

10.21203/rs.3.rs-47459/v1 ◽

2020 ◽

Author(s):

Riad Abdel Jalil ◽

Mohamad K. Abou Chaar ◽

Omar M. Shihadeh ◽

Obada Al-Qudah ◽

Azza Gharaibeh ◽

...

Keyword(s):

Single Port ◽

Thoracoscopic Surgery ◽

Treatment Options ◽

Tumor Resection ◽

Germ Cell Tumors ◽

Case Series ◽

Pulmonary Metastasectomy ◽

Abdominal Tumor ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

Abstract Background: Pulmonary metastasectomy was performed in the early twentieth century and ever since, it has evolved to be one of the main treatment options for certain metastatic malignancies. The advancement of minimally invasive procedures enabled new techniques to minimize morbidity and improve patient quality of care and overall outcome. Cases presentation: Herein we present three patients, aged 53, 48, and 27 years, known to have sigmoid, rectal, and non-seminomatous germ cell tumors respectively. All patients were diagnosed to have metastatic lung nodules and underwent laparotomy to excise abdominal tumors followed by trans-diaphragmatic single-port video-assisted thoracoscopic pulmonary metastasectomy. All patients achieved complete surgical tumor excision, and none had pulmonary related complications on follow-up.Conclusion: Our prescribed novel trans-diaphragmatic single-port video-assisted thoracoscopic surgery (VATS) technique for synchronous pulmonary metastasectomy and intra-abdominal tumor resection is safe and can achieve complete resection with negative margins.

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Video-assisted thoracoscopic surgery is a safe and effective method to treat intrathoracic unicentric Castleman’s disease

10.21203/rs.2.14795/v1 ◽

2019 ◽

Author(s):

Yan-qing Wang ◽

Shan-qing Li ◽

Feng Guo

Keyword(s):

Thoracoscopic Surgery ◽

Tumor Resection ◽

Castleman’S Disease ◽

Maximum Diameter ◽

Invasive Technique ◽

Castleman's Disease ◽

Video Assisted ◽

Vascular Type ◽

Complete Surgical Excision ◽

Video Assisted Thoracoscopic Surgery

Abstract Background: Castleman's disease (CD) is a rare non-clonal lymphadenopathy. Application of video-assisted thoracoscopic surgery (VATs) in intrathoracic unicentric Castleman's disease (UCD) is rarely reported. This study is aimed to clarify the role of VATs for diagnosis and treatment in intrathoracic UCD. Methods: The authors reviewed and identified patients who had received a histologic diagnosis of CD through VATs at our hospital from January2010 to June 2018. Clinical and radiologic variables, histopathology, type of approach, complications, and long-term effect were analyzed to evaluate the safety and efficacy of VATs. Results: A total of 10 patients were included in this study, with 8 hyaline vascular type and 2 plasma cell type. The mean maximum diameter of the lesions was 4.66cm. Nine cases underwent complete surgical excision by VATs, and 1 case was converted to thoracotomy. All patients had no postoperative complications. With a median follow-up of 5 years (range: 1-9 years), no tumor recurrence was found in 9 patients receiving complete tumor resection, and 1 patient with incomplete tumor resection remained symptom free without clinical or radiographic progression. Conclusions: VATs is an acceptable, minimally invasive technique which results in excellent rates of cure in patients with intrathoracic UCD.

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Transdiaphragmatic single-port video-assisted thoracoscopic surgery; a novel approach for pulmonary metastasectomy through laparotomy incision – case series

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01393-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Riad Abdel Jalil ◽

Mohamad K. Abou Chaar ◽

Omar M. Shihadeh ◽

Obada Al-Qudah ◽

Azza Gharaibeh ◽

...

Keyword(s):

Single Port ◽

Thoracoscopic Surgery ◽

Treatment Options ◽

Tumor Resection ◽

Germ Cell Tumors ◽

Case Series ◽

Pulmonary Metastasectomy ◽

Abdominal Tumor ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

Abstract Background Pulmonary metastasectomy was performed in the early twentieth century and ever since, it has evolved to be one of the main treatment options for certain metastatic malignancies. The advancement of minimally invasive procedures enabled new techniques to minimize morbidity and improve patient quality of care and overall outcome. Cases presentation Herein we present three patients, aged 53, 48, and 27 years, known to have sigmoid, rectal, and non-seminomatous germ cell tumors respectively. All patients were diagnosed to have metastatic lung nodules and underwent laparotomy to excise abdominal tumors followed by trans-diaphragmatic single-port video-assisted thoracoscopic pulmonary metastasectomy. All patients achieved complete surgical tumor excision, and none had pulmonary related complications on follow-up. Conclusion Our prescribed novel trans-diaphragmatic single-port video-assisted thoracoscopic surgery (VATS) technique for synchronous pulmonary metastasectomy and intra-abdominal tumor resection is safe and can achieve complete resection with negative margins.

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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

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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.

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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.

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