scholarly journals Vaizdo torakoskopijos reikšmė diagnozuojant ir gydant plaučių ir krūtinės ligas

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Renatas Aškinis ◽  
Vladislavas Vencevičius ◽  
Saulius Cicėnas
Keyword(s):  
Thoracic Surgery ◽  
Lung Metastases ◽  
Thoracoscopic Surgery ◽  
Preoperative Evaluation ◽  
Diagnosis And Treatment ◽  
Pleural Diseases ◽  
Video Assisted ◽  
The Mean ◽  
Vilnius University ◽  
Video Assisted Thoracoscopic Surgery

Renatas Aškinis, Vladislavas Vencevičius, Saulius CicėnasVilniaus universiteto Onkologijos instituto Krūtinės chirurgijos ir onkologijos skyrius,Santariškių g. 1, LT-08660 VilniusEl paštas: [email protected] Tikslas Įvertinti vaizdo torakoskopinių (VATS) operacijų galimybes diagnozuojant ir gydant plaučių ir krūtinės ligas. Ligoniai ir metodai Vilniaus universiteto Onkologijos instituto Krūtinės chirurgijos ir onkologijos skyriuje 1997–2006 m. buvo atlikta 415 vaizdo torakoskopinių operacijų. Tačiau mes šiame straipsnyje nagrinėjame gydymo rezultatus 106 (25,5%) ligonių, kuriems buvo atlikta rezekcinė plaučių ir pleuros operacija. Prieš operaciją ligoniams daryta krūtinės ląstos rentgenograma, ištirta kvėpavimo sistemos funkcija, atlikti echoskopiniai tyrimai. Kai reikėdavo patikslinti klinikinę patologiją, buvo atliekama fibrobronchoskopija ir kompiuterinė tomografija. Rezultatai Vilniaus universiteto Onkologijos instituto Krūtinės chirurgijos ir onkologijos skyriuje 1997–2006 m. buvo atliktos 106 vaizdo torakoskopinės rezekcinės operacijos. Iš jų: lobektomija – 6 (5,6%), kraštinė rezekcija dėl periferinio I stadijos nesmulkialąstelinio plaučių vėžio (NSLPV) – 13 (12,2%), plaučių metastazių šalinimas – 33 (31,1%), hamartomos rezekcija – 22 (20,7%), perikardo cistos pašalinimas – 3 (2,8%), perikardo rezekcija – 7 (6,6%), intratorakalinės lipomos pašalinimas – 9 (8,4%), kalcifikatų pašalinimas – 4 (3,7%), simpatektomija dėl Reino ligos – 9 (8,4%) ligoniams. Atlikdami plaučių skilties ar kraštines rezekcijas, naudojome endoskopinius staplerius ir siuvamuosius linijinius aparatus. Endoskopinės operacijos sutrumpino hospitalizacijos laiką iki 5 dienų. Pooperacinės komplikacijos pasireiškė 20 (18,8%) ligonių: pooperacinė pneumonija – 8 (40%) ligoniams, trumpalaikis pneumotoraksas – 2 (10%), pleuros empiema – 2 (10%), kraujavimas dėl plaučio atskyrimo nuo krūtinės ląstos sienos – 4 (20%), poodinė emfizema – 4 (20%). Visi ligoniai pasveiko gydomi konservatyviai. Išvados Vaizdo torakoskopinė chirurgija yra veiksmingas, saugus ir patikimas plaučių ir pleuros ligų gydymo metodas. Endoskopinė chirurgija kartais yra vienintelis galimas būdas pašalinti periferinius navikus, mažinti ligonių lovadienių skaičių bei greičiau pradėti sudėtinį gydymą. Vaizdo torakoskopinė chirurgija galima ligoniams, vyresniems kaip 70 metų bei sergantiems kvėpavimo ir širdies nepakankamumo ligomis, kai tipinė torakotomija negalima. Pagrindiniai žodžiai: vaizdo torakoskopinė chirurgija, periferiniai plaučių navikai, kraštinė ir kylinė plaučių audinio rezekcija Videothoracoscopy (VATS) in the diagnosis and treatment of lung and chest diseases Renatas Aškinis, Vladislavas Vencevičius, Saulius CicėnasVilnius University Institute of Oncology, Department of Thoracic Surgery and Oncology,Santariškių str. 1, LT-08660 Vilnius, LithuaniaE-mail: [email protected] Objective To evaluate the efficacy of videothoracoscopic (VATS) operations in diagnosis and treatment of lung and chest diseases. Patients and methods In 1997–2006, 415 videothoracoscopies were performed at Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University. In this article, we analyse the possibilities of video-assisted thoracoscopic surgery used in 106 (25.5%) pts to whom lung and pleural resections were performed. Preoperative evaluation included chest radiography, respiratory function test and sonoscopical investigation. Flexible bronchoscopy and chest CT were performed when clinically indicated. Results In 1997–2006, at Institute of Oncology of Vilnius University, using video-assisted thoracoscopic surgery 106 resection of operations were performed: lobectomies – 6 (5.6%) pts, wedge resections lung tissue to I0NSCLC – 13 (12.2%) pts, removed lung metastases – 33 (31.1%) pts, removed hamartomas – 22 (20.7%) pts, pericardial cystectomies with electrocoagulation – 3 (2.8%) pts, resections of pericardium – 7 (6.6%) pts, resections of intrathoracal lipomectomies – 9 (8.4%) pts, calcificate – 4 (3.7%) pts, sympatectomies for patients with Raynaud‘s disease – 9 (8.4%) pts. Wedge and marginal endoscopic resections of the lung and lobectomy were performed using endoscopic staplers and endoscopic sewing equipment. Endoscopic operations shorten hospitalization and a quicker start of complex treatment. The mean period of our patients’ hospitalization was 5 days. After video-assisted thoracoscopic resection we had complications in 20 (18.8%) pts. All patients recovered. Conclusions Video-assisted thoracoscopic surgery (VATS) is aneffective and safe method of treatment for lung and pleural diseases. In some cases, VATS is the only way to remove tumors, and it shortens hospital stay to 5 days. VATS surgery is very effective in elderly patients with concomitant diseases. Keywords: video-assisted thoracoscopic surgery, peripherical lung tumors, wedge and marginal resection, lobectomy

Nonintubated Uniportal Thoracoscopic Thymectomy with Laryngeal Mask

2019 ◽  
Vol 68 (05) ◽  
pp. 450-456 ◽  
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.

scholarly journals Robotic pulmonary lobectomy for lung cancer treatment: program implementation and initial experience

2016 ◽  
Vol 42 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Ricardo Mingarini Terra ◽  
Pedro Henrique Xavier Nabuco de Araujo ◽  
Leticia Leone Lauricella ◽  
José Ribas Milanez de Campos ◽  
Herbert Felix Costa ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Sao Paulo ◽  
Pathological Examination ◽  
São Paulo ◽  
Pulmonary Lobectomy ◽  
Video Assisted ◽  
Tertiary Teaching ◽  
Video Assisted Thoracoscopic Surgery

ABSTRACT Objective: To describe the implementation of a robotic thoracic surgery program at a public tertiary teaching hospital and to analyze its initial results. Methods: This was a planned interim analysis of a randomized clinical trial aimed at comparing video-assisted thoracoscopic surgery and robotic surgery in terms of the results obtained after pulmonary lobectomy. The robotic surgery program developed at the Instituto do Câncer do Estado de São Paulo, in the city of São Paulo, Brazil, is a multidisciplinary initiative involving various surgical specialties, as well as anesthesiology, nursing, and clinical engineering teams. In this analysis, we evaluated the patients included in the robotic lobectomy arm of the trial during its first three months (from April to June of 2015). Results: Ten patients were included in this analysis. There were eight women and two men. The mean age was 65.1 years. All of the patients presented with peripheral tumors. We performed right upper lobectomy in four patients, right lower lobectomy in four, and left upper lobectomy in two. Surgical time varied considerably (range, 135-435 min). Conversion to open surgery or video-assisted thoracoscopic surgery was not necessary in any of the cases. Intraoperative complications were not found. Only the first patient required postoperative transfer to the ICU. There were no deaths or readmissions within the first 30 days after discharge. The only postoperative complication was chest pain (grade 3), in two patients. Pathological examination revealed complete tumor resection in all cases. Conclusions: When there is integration and proper training of all of the teams involved, the implementation of a robotic thoracic surgery program is feasible and can reduce morbidity and mortality.

scholarly journals May awake video-assisted thoracoscopic surgery with thoracic epidural anesthesia use routinely for minimaly invasive thoracic surgery procedures in the future?

2018 ◽  
Vol 5 (5) ◽  
pp. 1602
Author(s):  
Gonul Sagiroglu ◽  
Fazli Yanik ◽  
Yekta A. Karamusfaoglu ◽  
Elif Copuroglu
Keyword(s):  
Thoracic Surgery ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Thoracoscopic Surgery ◽  
Lung Ventilation ◽  
Thoracic Epidural Anesthesia ◽  
One Lung Ventilation ◽  
Thoracic Epidural ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Background: In the last years thoracic surgery developed in greater extent with equipments and techniques in one lung ventilation. Still general anesthesia in one lung ventilation approved as gold standard. In thoracic surgery most performed surgeries are plerural decortication and lung biopsy. Avoidance of intubation in Video Assisted Thoracoscopic Surgery (VATS) procedures gains us some advantages in postoperative period; a better respiratory parameters, survival and morbidity mortality rates, reduced hospitalization time and costs, reduced early stress hormone and immune response.  Methods: In this study, we reported our experience of 24 consecutive patients undergoing VATS with Thoracic Epidural Anesthesia (TEA) between December 2015 through July 2016 to evaluate the feasibility, safety and indication of this innovative technique whether it will be a gold standart in thoracic surgeries or not in the future.Results: Operation procedures included wedge resection in 11 (46%) patients (eight of them for pneumothorax, three of them for diagnosis), in 10 (42%) patients pleural biopsy (eight of them used talc pleurodesis), in two (8%) patients air leak control with fibrin glue and in one (4%) patient bilateral thoracal sympathectomy for hyperhidrosis.  We used T4-5 TEA space for 17 (72%) of patients, while we used T4-6 TEA space for 7 (28%) of patients. TEA block reached the desired level after the mean 26.4±4.3 minutes (range 21-34 min). There was no occurrence of hypotension and bradycardia during and after TEA. One (4%) patient required conversion to general anesthesia and tracheal intubation because of significant diaphragmatic contractions and hyperpne. Conversion to thoracotomy was not needed in any patient.Conclusions: We conclude that nVATS procedure with aid of TEA is feasibile and safety with minimal adverse events. The procedure can have such advantages as early mobilization, opening of early oral intake, early discharge, patient satisfaction, low pain level. Nevertheless, there is a need for randomized controlled trials involving wider case series on the subject.

scholarly journals Uniportal video-assisted thoracoscopic carinal resections: technical aspects and outcomes

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i58-i64
Author(s):  
Dmitrii Sekhniaidze ◽  
Diego Gonzalez-Rivas ◽  
Pavel Kononets ◽  
Alejandro Garcia ◽  
Vladimir Shneider ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Thoracoscopic Surgery ◽  
Morbidity Rate ◽  
Surgical Time ◽  
Technical Aspects ◽  
Video Assisted ◽  
The Mean ◽  
Clinic Hospital ◽  
Blood Loss Volume ◽  
Video Assisted Thoracoscopic Surgery

Abstract OBJECTIVES Important benefits in uniportal video-assisted thoracoscopic surgery (VATS) for lung cancer have recently been achieved. However, the use of this technique for complex sleeve procedures is limited. We describe the technical aspects of and patient outcomes following carinal resections using uniportal VATS. METHODS Since 2015, 16 sleeve carinal resections, including 11 right pneumonectomies, 4 right upper lobectomies and 1 lung-sparing carinal resection, have been performed at the Regional Clinic Hospital, Tyumen, Russia. RESULTS The mean surgical time was 215.9 ± 67.2 min (range 125–340 min). The mean blood loss volume was 256.3 ± 284.5 ml (range 50–1200 ml). There was 1 case of conversion to thoracotomy. The morbidity rate was 25%, and the mortality rate was 0%. The median overall survival was 38.6 ± 3.5 months. CONCLUSIONS The use of uniportal VATS for carinal resections in certain patients allows for radical resections with low rates of morbidity and mortality.

A Video-Assisted Thoracoscopic Approach to Transaxillary First Rib Resection

2015 ◽  
Vol 10 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Harmik J. Soukiasian ◽  
Daniel Shouhed ◽  
Derek Serna-Gallgos ◽  
Robert McKenna ◽  
Vahak J. Bairamian ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Thoracoscopic Surgery ◽  
Invasive Approach ◽  
Thoracoscopic Approach ◽  
Rib Resection ◽  
Video Assisted ◽  
First Rib ◽  
The Mean ◽  
First Rib Resection ◽  
Video Assisted Thoracoscopic Surgery

Objective Thoracic outlet syndrome (TOS) can be associated with neurologic, arterial, or venous deficiencies. When nonsurgical treatment has failed to adequately palliate TOS, surgical intervention is indicated. The supraclavicular and transaxillary approaches are currently the most commonly used approaches for first rib resection, yet little has been reported to date on outcomes of minimally invasive procedures, such as video-assisted thoracoscopic surgery (VATS). The purpose of this article was to describe a minimally invasive approach to TOS and the associated outcomes. Methods This study is a retrospective analysis of a prospectively maintained database. Patients who failed nonsurgical therapy for TOS were referred to our practice for evaluation of surgery with a VATS minimally invasive first rib resection. Between 2001 and 2010, 66 VATS procedures were performed on 58 patients (41 women, 17 men). Patients were followed postoperatively for a mean time of 13.5 months. Results Forty-one patients were women (70.7%), and the mean age was 40.5 years, with a patient age range of 17 to 59 years. The mean length of hospital stay was 2.47 days; median length of stay was 2 days. There were a total of eight complications (12.1%). There were no mortalities. Conclusions Video-assisted thoracoscopic surgery first rib resection for TOS is another feasible option for TOS, which can be added to the armamentarium of the thoracic surgeon. The outcomes associated with our technique are comparable with the outcomes related to other current standards of care.

Video-Assisted Thoracoscopic Surgery for Resection of Lung Metastases

CHEST Journal ◽  
1998 ◽  
Vol 113 (1) ◽  
pp. 2S-5S ◽  
Author(s):  
Robert D. Dowling ◽  
Rodney J. Landreneau ◽  
Daniel L. Miller
Keyword(s):  
Lung Metastases ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Surgeon-Powered Robotics in Thoracic Surgery; An Era of Surgical Innovation and Its Benefits for the Patient and Beyond

2020 ◽  
Vol 7 ◽  
Author(s):  
Jason Trevis ◽  
Nicholas Chilvers ◽  
Kathrin Freystaetter ◽  
Joel Dunning
Keyword(s):  
Robotic Surgery ◽  
Minimally Invasive ◽  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Surgical Innovation ◽  
Video Assisted ◽  
3D Camera ◽  
Minimally Invasive Thoracic Surgery ◽  
Video Assisted Thoracoscopic Surgery

Following its introduction in 1992, the growth of minimally invasive thoracic surgery was initially hampered by the lack of specialized instruments, impeded visualization and stapling. However, in subsequent years these challenges were somewhat overcome and video-assisted thoracoscopic surgery (VATS) became the preferred modality of many centers. More recently, robotic surgery has come to the fore. Whilst it offers outstanding precision via robotic wristed instruments, robotic surgery is expensive and has safety implications as the surgeon is away from the patient's side. Wristed VATS instruments offer a new, exciting alternative. By placing the robotic-like wristed instruments in the hands of the surgeon, a concept we call surgeon-powered robotics, the benefits of robotic surgery can be achieved by the patient's side. We describe our experience of the ArtiSential® wristed instruments and discuss the benefits and challenges of this technology. By combining wristed instruments with the latest surgeon-controlled 3D camera technology, surgeon-powered robotics is an affordable reality.

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