Tips and tricks

  • Dominique Gossot
Chapter

Abstract

Totally endoscopic lobectomies or segmentectomies are considered as challenging. Because of the endoscopic vision with its magnification and unusual viewpoints, the anatomical landmarks are changed. In addition, restricted tissue manipulation and use of endoscopic instruments are disturbing. Eventually, as mentioned by T. L. Demmy, performing endoscopic major pulmonary resection means relearning the procedures. The aim of this chapter is to stress several technical details that we have found helpful. Most of these tips and tricks can be modified according to the surgeon’s preferences and will anyway evolve with upcoming technologies. The key-points are:

Keywords

Main Pulmonary Artery Suction Device Endoscopic Instrument Lower Lobectomy Bipolar Vessel 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Bibliography

General aspects

  1. Demmy T, James T, Swanson S, et al. (2005) Troubleshooting video-assisted thoracic surgery lobectomy. Ann Thorac Surg 79:1744–1753CrossRefPubMedGoogle Scholar
  2. Gossot D (2008) Technical tricks to facilitate totally endoscopic major pulmonary resections. Ann Thorac Surg 86:323–326CrossRefPubMedGoogle Scholar
  3. Park B, Flores R, Rusch V (2006) Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results. J Thorac Cardiovasc Surg 131:54–59CrossRefPubMedGoogle Scholar
  4. Shiraishi T, Shirakusa T, Miyoshi T, et al. (2006) A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer: technique, feasability and advantages. Thorac Cardiovasc Surg 54:202–207CrossRefPubMedGoogle Scholar
  5. Gossot D, Merlusca G, Tudor A, et al. (2009) Pitfalls related to the use of endostaplers during video-assisted thoracic surgery. Surg Endosc 23:189–192CrossRefPubMedGoogle Scholar
  6. Gossot D, Pryschepau M, Barenys CM, et al. (2009) Throw-off instruments for advanced thoracoscopic procedures. Interact Cardiovasc Thorac Surg 10:159–160CrossRefPubMedGoogle Scholar
  7. Ikeda Y, Tamura M, Umezu H, et al. (2003) Usefulness of mini loop retractor in video-assisted thoracic surgery. Kyobu Geka 56:199–202PubMedGoogle Scholar
  8. Ito N, Suda T, Inoue T, et al. (2005) Use of a soft silicone tube guide for an automatic suture device in video-assisted lung lobectomy. J Thorac Cardiovasc Surg 130:931–932CrossRefPubMedGoogle Scholar
  9. Kondo K, Adachi H (2006) Minimally invasive surgery for lung cancer using thoracoscope as a “microscopic surgery” for the safety endoscopic surgery. Kyobu Geka 59:703–709PubMedGoogle Scholar
  10. Sato Y, Tezuka Y, Kana iY, et al. (2008) Novel retractor for lymph node dissection by video-assisted thoracic surgery. Ann Thorac Surg 86:1036–1037CrossRefPubMedGoogle Scholar
  11. Schoofs J, Gossot D (2004) A neglected but frustrating ergonomic issue: the thoracoscopic trocar. Minim Invasive Ther Allied Technol:133–137Google Scholar
  12. Molnar T, Benko I, Szanto Z, et al. (2006) Lung biopsy using harmonic scalpel: a randomised single institute study. Eur J Cardiothor Surg 28:604–606CrossRefGoogle Scholar
  13. Sakuragi T, Okazaki Y, Mitsuoka M, et al. (2008) The utility of a reusable bipolar sealing instrument, BiClamp, for pulmonary resection. Eur J Cardiothor Surg 34:505–509CrossRefGoogle Scholar
  14. Santini M, Vicidomini G, Baldi A, et al. (2006) Use of an electrothermal bipolar tissue sealing system in lung surgery. Eur J Cardiothor Surg 29:226–230CrossRefGoogle Scholar
  15. Tanaka K, Hagiwara M, Kondo Y, et al. (2006) Usefulness of ultasonically activated scalpel for pulmonary resection in video-assisted thoracoscopic surgery. Kyobu Geka 59:1171–1175PubMedGoogle Scholar
  16. Fukuhara K, Akashi A, Nakane S, Tomita E (2008) Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before videoassisted thoracic surgery lobectomy. Eur J Cardiothor Surg 34:875–877CrossRefGoogle Scholar
  17. Nakanishi R, Oka S, Odate S (2009) Video-assisted thoracic surgery major pulmonary resection requiring control of the main pulmonary artery. Interact Cardiovasc Thorac Surg;9:618–22CrossRefPubMedGoogle Scholar
  18. Nomori H, Ohtsuka T, Horio H, et al. (2003) Thoracoscopic lobectomy for lung cancer with a largely fused fissure. Chest 123:619–622CrossRefPubMedGoogle Scholar
  19. Oda M, Ishikawa N, Tsunezuka Y, et al. (2007) Closed three-port anatomic lobectomy with systematic nodal dissection for lung cancer. Surg Endosc 21:1464–1465CrossRefPubMedGoogle Scholar
  20. Okada M, Mimura T, Ikegaki J, et al. (2007) A novel video assisted anatomic segmentectomy technique: selective segmental inflation via bronchofiberoptic jet followed by cautery cutting. J Thorac Cardiovasc Surg 133:753–758CrossRefPubMedGoogle Scholar
  21. Watanabe A, Koyanagi T, Nakashima S, Higami T (2007) How to clamp the main pulmonary artery during video-assisted thoracoscopic surgery lobectomy. Eur J Cardiothor Surg 31:129–131CrossRefGoogle Scholar
  22. Wauben L, van Veelen M, Gossot D, Goossens R (2006) Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons. Surg Endosc 20:1268–1274CrossRefPubMedGoogle Scholar
  23. Yamada S, Suga A, Inoue Y et al. (2009) Use of multi-detector rox angiography for the arrangement of video-asisted modified segmental resection. Eur J Cardiothor Surg 36:727–30CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France, Paris 2010

Authors and Affiliations

  • Dominique Gossot
    • 1
  1. 1.Thoracic DepartmentInstitut Mutualiste MontsourisParisFrance

Personalised recommendations