scholarly journals Postero-apical thoracic schwannoma with cervical extension resected by complete video-assisted thoracoscopic surgery

2019 ◽  
Vol 89 (2) ◽  
Author(s):  
Harry Etienne ◽  
Apostolos C. Agrafiotis ◽  
Hicham Masmoudi ◽  
Jalal Assouad
Keyword(s):  
Nervous System ◽  
Thoracic Surgery ◽  
Brachial Plexus ◽  
Subclavian Artery ◽  
Thoracoscopic Surgery ◽  
Benign Tumors ◽  
Neurogenic Tumors ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery ◽  
Risk Of Relapse

Schwannomas or neurilemmomas are benign tumors developed from the peripheral nervous system. Complete video-assisted thoracic surgery (cVATS) has set itself over the years as the preferred approach for the removal of small mediastinal neurogenic tumors. However, in case of apical location, complete VATS seems challenging because of proximity with the subclavian artery and/or elements of the brachial plexus. In case of a cVATS procedure, some authors prefer enucleation instead of resection, with a higher risk of relapse. We present two cases of cVATS resection of thoracic apical schwannomas.

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 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.

scholarly journals Localization of subcentimeter pulmonary nodules using an indocyanine green near-infrared imaging system during uniportal video-assisted thoracoscopic surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhuo Wu ◽  
Lei Zhang ◽  
Xi-tong Zhao ◽  
Di Zhou ◽  
Xue-ying Yang
Keyword(s):  
Thoracic Surgery ◽  
Indocyanine Green ◽  
Near Infrared ◽  
Imaging System ◽  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Surgical Time ◽  
Widespread Application ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background To investigate the feasibility of indocyanine green (ICG) use in localizing subcentimeter pulmonary nodules during uniportal video-assisted thoracoscopic surgery. Methods This study was a retrospective analysis of 32 patients who underwent surgery due to pulmonary nodules using ICG localization from September 2019 to March 2020 in the Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University. Laser positioning and large-aperture spiral CT simulation were performed preoperatively. ICG was injected into the lung (2.5 mg/ml). The clinical characteristics and postoperative indicators were recorded. Results A total of 33 subcentimeter pulmonary nodules were successfully localized in 32 patients. Twenty-three patients underwent lobectomy, with an average surgical time of 45.3 min and an average tube retention time of 2 days. Non-small cell lung cancer was confirmed intraoperatively in 9 patients, among whom the longest surgical time was 120 min, and the shortest hospital stay was 7 days. No patient was converted to thoracotomy or developed serious complications. Conclusions ICG imaging is a safe and effective technique for localization of pulmonary nodules. Due to the widespread application of near-infrared devices, fluorescent localization and imaging technology will be more widely used in thoracic surgery.

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.

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