Exploration and evacuation of pleural space, pleurodesis, surgery for stage i and ii thoracic empyema are evidenced fields of vats procedures. It is reported to reduce med j malaysia vol 51 no 1 march 1996. Vats is principally employed in the manage ment of pulmonary, mediastinal, and pleural pathology. Y m lee, frcs y c lim, frcs c k liam, mrcp m aljafri, frcscth cardiothoracic unit, department of surgery department of medicine, university of malaya, lembah pantai, 59100 kuala lumpur introduction spontaneous pneumothorax is a common condition. The patients were all men, with ages ranging from 19 to 28 years mean 23. The thorascope transmits images of the inside of the chest on a video monitor, guiding the surgeon in maneuvering the instruments to complete the procedure. Role of video thoracoscopy in management of malignant pleural effusion. Videoassisted thoracoscopic surgery vats is a surgical procedure that allows doctors to see inside the chest and lungs.
Statistical analysis metaanalysis was done by combining the results of reported recurrence rates in patients undergoing videoassisted thoracoscopic surgery compared with. Videoassisted thoracic surgery vats is the treatment of choice of psp if aspiration fails or if pneumothorax recurs see chapter 24. Videoassisted thoracoscopic surgery for the treatment of. Vats lobectomy represents a true success story, a surgical approach which has matured over the past decades and now accounts for approximately 45% of all lobectomies in the. Surgery is the cornerstone of early stage nonsmall cell lung cancer nsclc treatment, and lobectomy is currently the preferred type of lung resection for clinical stages i and ii of nsclc.
When applied to the patient with lung cancer, the therapeutic benefit of vats lobectomy appears to be confined to nodenegative, relatively small tumors. Background videoassisted thoracoscopic surgery vats is minimally invasive thoracic surgery that does not use a formal thoracotomy incision. There seems to be a paucity in literature over the established use of vats in traumatic injuries of. Videoassisted thoracoscopic surgery for pneumothorax. The surgical procedures included patent ductus arteriosus interruption n 28 and vascular ring division n 8, and 9 patients had miscellaneous procedures. Whether videoassisted thoracoscopic surgery vats segmentectomy and vats lobectomy provide similar perioperative and oncological outcomes in stage i nonsmall cell lung cancer nsclc is still controversial. Videoassisted thoracoscopic surgery versus musclesparing. The technique of videoassisted thoracic surgery vats is a wellestablished technique in the armamentarium of the thoracic surgeon and currently indicated for a wide spectrum of pulmonary. Over the last 3 years, we performed 459 videoassisted thoracoscopic procedures. Videoassisted thoracoscopic surgery vats mayo clinic. Several studies have shown that in contrast to lobectomy by open thoracotomy, video assisted thoracic surgery vats for lobectomy is asso ciated with lower. This booklet will explain the reasons for the operation, the procedure itself and potential risks involved. The camera and instruments are inserted through separate holes in the chest wall.
Videoassisted thoracoscopic surgery vats technique. Other diagnostic procedures are performed on the mediastinum for biopsy of lymph nodes not accessible via traditional. During a vats procedure, a tiny camera thoracoscope and surgical instruments are inserted into your chest through one or more small incisions in your chest wall. The amount of blood drainage ranged from 650 to 2300 ml. Videoassisted thoracoscopic surgery was repeated in 32. Although the first recorded use of videoassisted thoracoscopic surgery vats in trauma goes back to 1946. Videoassisted thoracoscopic surgery stanford university. Video assisted thoracoscopic surgery pubmed central pmc. Videoassisted thoracoscopic surgery versus robotassisted. Videoassisted thoracoscopic surgery for pulmonary sequestration in children. Anesthesia for video assisted thoracoscopic surgery 333 the entire chest cavity, essentially has replaced the traditional minithoracotomy particularly in cases where percutaneous needle aspiration biopsy is inconclusive. The surgeon is able to view the instruments that are being used along with the anatomy on which the surgeon is operating. Videoassisted thoracoscopic surgical decortication vatsd is widely used for treatment of early empyema and hemothorax, but conversion to open thoracotomy for decortication od is more frequent in the setting of complex, chronic empyema. Vats provides adequate visualization despite limited access to the thorax, allowing the procedure to be performed in a state of debilitation and for patients who have marginal pulmonary reserve.
This study compared indications for and outcomes associated with vatsd and od. Uniportal vats lobectomy has shown to be associated with less postoperative pain and analgesia requirement, less duration of postoperative intercostal chest tube drainage, and also reported shorter recovery time when. Dr anand nadkarni videoassisted thoracoscopic surgery download the pdf file. Videoassisted thoracoscopic surgery vats has been recently introduced as. Without a doubt, videoassisted thoracoscopic surgery vats has completely revolutionized modern thoracic surgery and significantly improved patient outcomes over the last two decades. Robotic versus open and videoassisted thoracoscopic. Videoassisted thoracoscopic surgery in the treatment of. Videoassisted thoracoscopic surgery vats is a minimally invasive surgical technique used to diagnose and treat problems in your chest. Early experience of videoassisted thoracoscopic surgery. The question addressed was in patients undergoing videoassisted thoracoscopic thymectomy for myasthenia gravis mg is a leftsided approach superior to a rightsided approach in terms of clinical outcome. Studies have suggested videoassisted thoracoscopic surgery vats as a standard approach in the treatment of a recurrent or persistent sp.
Video assisted thoracoscopy is now a well established technique in the armamentarium of the thoracic surgeon. Video assisted thoracic surgery linkedin slideshare. Pdf videoassisted thoracoscopic surgery for pulmonary. Gymnopoulos 2 1cardiothoracic department medical university of evros, 2private clinic, komotini, greece abstract videoassisted thoracic surgery is finding an everincreasing role in the diagnosis and treatment. Thoracoscopy and videoassisted thoracic surgery vats are increasingly utilized for a variety of diagnostic and therapeutic procedures, including the parenchymal lung disease, pleural disease, spontaneous pneumothorax, sympathectomy, esophageal disease, and in the assessment of various mediastinal lesions. Common surgical methods include thoracotomy and thoracoscopic surgery. Yet, a direct comparison between the effects of mst and. Videoassisted thoracoscopic surgery vats is widely accepted as a standard approach for the surgical treatment of stages i and ii nonsmall cell lung cancers. Videoassisted thoracoscopic surgery vats is a type of thoracic surgery performed using a small video camera that is introduced into the patients chest via small incisions. He performed adhesiolysis to enhance pneumothorax therapy of tuberculosis via a cystoscope introduced into the pleural cavity. Videoassisted thoracoscopic treatment of spontaneous pneumothorax. Minimally invasive approaches, namely videoassisted thoracoscopic surgery vats and roboticassisted thoracoscopic surgery rats, are preferred for early stage.
Introduction videoassisted thoracoscopic surgery vats is a minimally invasive surgical procedure, used to diagnose and treat illness or injury to the lung and other organs in thorax. Videoassisted thoracoscopic surgery versus roboticassisted thoracoscopic surgery in the surgical treatment of masaoka stage i thymoma, world journal of surgical oncology, 20, pp. Jacobaeus is credited with the technique of thoracoscopy and the first clinical application dates from 19. Pdf on oct 1, 2000, serban c stoica and others published video assisted thoracoscopic surgery find, read and cite all the research you need on. Recurrence rates of videoassisted thoracoscopic versus. Metaanalysis of 12 studies comparing outcomes after vats lobectomy and vats segmentectomy for stage i nsclc. Videoassisted thoracoscopic pulmonary surgerycurrent status and potential evolution. Brodskya and edmond cohenb videoassisted thoracic surgery is finding an everincreasing role in the diagnosis and treatment of a wide range of thoracic disorders that previously required sternotomy or open thoracotomy. It is a form of keyhole surgery which can be used to do a number of different surgical procedures. Videoassisted thoracoscopic surgery jianxing he, tristan d. During vats, a tiny camera with a light source is inserted through a small incision between the ribs. Videoassisted thoracoscopic surgery is a safe and effective. Recently, uniportal videoassisted thoracoscopic surgery vats of lung resection is growing in many thoracic surgery units all over the world.
Image guided video assisted thoracoscopic surgery ivats assisted by cone beam ct and 3d live needle guidance patient history this is a 57 years old male presenting with an increasing right upper lobe lung nodule. Video assisted thoracic surgery vats seminar presented by dr. Videoassisted thoracoscopic surgery using mobile computed. A best evidence topic in thoracic surgery was written according to a structured protocol. Video assisted thoracoscopic surgery vats is principally employed in the management of pulmonary, mediastinal, and pleural pathology. Graphic abstract lung resection is a mainstay of therapy for earlystage lung cancer. Thoracoscopic surgery has become increasingly popular since the early nineties for a wide range of general thoracic surgical procedures. In comparison to open thoracotomy, this minimally invasive procedure reduces the length of hos. Introduction surgical resection of lung nodules via videoassisted thoracoscopic surgery vats is one of the treatments available for early stage lung cancer. The aim of this prospective study was to evaluate videoassisted thoracoscopic surgery vats in primary and secondary spontaneous pneumothoraces. Primary spontaneous pneumothorax psp is a benign disease frequently found in younger and healthylooking persons. Videoassisted thoracoscopic surgery versus robotic. Other names for this procedure include thoracoscopy, thoracoscopic surgery or pleuroscopy, during thoracoscopic surgery, three. Videoassisted thoracoscopic surgery for complex mediastinal mass resections m.
The journal videoassisted thoracic surgery publishes invited articles and submitted papers on visualized thoracic surgical procedures, ecomments on all. From july 20 to november 20, 10 patients with small lung nodules or ground glass nodules underwent videoassisted thoracoscopic surgery using the oarm. Uniportal videoassisted thoracoscopic lobectomy surgery. Surgery for small lung tumors was performed based on intraoperative computed tomography images obtained using the oarm. Video assisted thoracoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stage i nonsmall cell lung cancer galal ghaly, md, mohamed kamel, md, abu nasar, ms, subroto paul, md, paul c. A consecutive series of patients with recurrent pleural effusions underwent vats using an slet and only one incision. Pdf video assisted thoracoscopic surgery researchgate. Impact on healthrelated quality of life of videoassisted.
Holzner1 1division of thoracic surgery, department of surgery, 2department of anesthesia, medstar georgetown university hospital, washington, dc 2007, usa correspondence to. Minimal invasive surgery has potential superiorities of optimizing surgical indications, including safety, feasibility, less invasiveness, and a better quality of life. Many outcome advantages have been cited in supporting vats and rats over thoracotomy for patients with stage i lung cancer. He performed adhesiolysis to enhance pneumothorax therapy of tuberculosis via a cystoscope introduced into the pleural. Gary lee mbchb, phd, in murray and nadels textbook of respiratory medicine sixth edition, 2016. The introduction of video imaging technology and the wider availability of stapling devices facilitated an increasingly wider use of thoracoscopy for diagnostic and therapeutic procedures. Pdf videoassisted thoracoscopic surgery for spontaneous. Videoassisted thoracoscopic surgery for spontaneous. Vats videoassisted thoracic surgery is a type of minimally invasive thoracic surgery of the chest, performed with a thoracoscope small videoscope using small incisions and special instruments to minimize trauma. Videoassisted thoracoscopic surgery vats has without a doubt revolutionized the practice of thoracic surgeons and improved patient experiences and outcomes worldwide.
This study evaluated the usefulness of the oarm in thoracic surgery. He was a current smoker 2 packs per day and had a smoking history of over 100 pack years. Similarly, videoassisted thoracoscopic surgery vats is fast becoming an accepted modality and has made an important impact on the practice of thoracic surgery4,5. Videoassisted thoracoscopic surgery, or vats, is a minimally invasive surgical procedure used to diagnose and treat illness or injury to the lung and other organs in the chest cavity thorax.
In a metaanalysis of 27 studies, the recurrence rate was only 5. Anesthesia case management for videoassisted thoracoscopic surgery article pdf available in aana journal 811. It requires a surgical treatment in about 3040% of cases. Image guided video assisted thoracoscopic surgery ivats. Outcomes of videoassisted thoracoscopic decortication. Videoassisted thoracoscopic surgery vats is emerging as a therapeutic option for a variety of thoracic applications. We evaluated a singlelumen endotracheal tube slet for vats for drainage of pleural effusions and pleural biopsies.
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