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Muranishi Y, Sato T, Ueda Y, Yutaka Y, Nakamura T, Date H. A novel suction-based lung-stabilizing device in single-port video-assisted thoracoscopic surgical procedures. Gen Thorac Cardiovasc Surg 2019; 68:503-507. [PMID: 31728836 DOI: 10.1007/s11748-019-01249-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/06/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Single-port video-assisted thoracoscopic surgery (SPVATS) has become a subject of interest for thoracic surgeons in recent years; however, it has not been fully accepted partly because the procedure is technically demanding. We speculate that the most critical problem of SPVATS is that significant interferences of the instruments may occur during the procedure because all the instruments share only a single incisional port. The purpose of this study was to evaluate the usability of a new suction-based lung-stabilizing device during SPVATS procedure. METHODS We developed a novel suction-based lung-stabilizing device equipped with three hemispheric silicon suction cups. Ten cases of canine's lower lobectomies were performed. Five cases were performed without this device and designated as the control cases. The remaining cases were performed using this device and were designated as the experimental cases. RESULTS A significantly fewer number of interruption times were noted in the novel lung-stabilizing device group than in the control group (average, 0.4 vs. 4.4; P = 0.0031). Although the differences did not reach statistical significance, the device tended to demonstrate better performance compared with the control group regarding the operation time, organ damage, and accomplishment of SPVATS. CONCLUSION Our study indicates that the novel lung-stabilizing device has potentially useful applications in SPVATS procedures.
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Affiliation(s)
- Yusuke Muranishi
- Department of Thoracic Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Toshihiko Sato
- Department of General Thoracic Surgery, Breast and Pediatric Surgery, Fukuoka University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan.
| | - Yuichiro Ueda
- Department of General Thoracic Surgery, Breast and Pediatric Surgery, Fukuoka University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
- Department of Organ and Tissue Reconstruction, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Yojiro Yutaka
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
- Department of Organ and Tissue Reconstruction, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Tatsuo Nakamura
- Department of Organ and Tissue Reconstruction, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
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Bertolaccini L, Batirel H, Brunelli A, Gonzalez-Rivas D, Ismail M, Ucar AM, Ng CSH, Scarci M, Sihoe ADL, Ugalde PA, Abu Akar F, Bedetti B, Nadal SB, Brandolini J, Crucitti P, Enyedi A, Fernando HC, Furak J, Gallego-Poveda J, Galvez-Munos C, Hanke I, Hernandez-Arenas LA, Janik M, Juhos P, Libretti L, Lucciarini P, Macrì P, Margaritora S, Mahoozi HR, Nachira D, Pardolesi A, Pischik V, Sagan D, Schreurs H, Sekhniaidze D, Socci L, Tosi D, Turna A, Vannucci F, Zielinski M, Rocco G. Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg 2019; 56:224-229. [DOI: 10.1093/ejcts/ezz133] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/07/2019] [Accepted: 03/20/2019] [Indexed: 01/05/2023] Open
Abstract
Abstract
OBJECTIVES
Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main procedural steps, optimize its indications and perioperative management and identify elements to assist in future training.
METHODS
The 40 members of the working group were convened and organized on a voluntary basis by the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). An e-consensus finding exercise using the Delphi method was applied to require 75% agreement for reaching consensus on each question. Repeated iterations of anonymous voting continued for 3 rounds.
RESULTS
Overall, 31 international experts from 18 countries completed all 3 rounds of questionnaires. Although a technical quorum was not achieved, most of the responders agreed that the maximum size of a UniVATS incision should be ≤4 cm. Agreement was reached on many points outlining the currently accepted definition of a UniVATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions.
CONCLUSIONS
The UVIG Consensus Report stated that UniVATS offers a valid alternative to standard VATS techniques. Only longer follow-up and randomized controlled studies will predict whether UniVATS represents a valid alternative approach to multiport VATS for major lung resections or whether it should be performed only in selected cases and by selected centres. The next step for the ESTS UVIG is the establishment of a UniVATS section inside the ESTS databases.
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Affiliation(s)
- Luca Bertolaccini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
| | | | - Diego Gonzalez-Rivas
- Minimally Invasive Thoracic Surgery Unit (UCTMI), Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany
| | | | - Calvin S H Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Marco Scarci
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Alan D L Sihoe
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai, China
| | - Paula A Ugalde
- Department of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Quebec, Canada
| | - Firas Abu Akar
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Israel
- Department of Cardiothoracic Surgery, Shaare Zedek Medical Center (SZMC), Jerusalem, Israel
| | | | | | - Jury Brandolini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | | | - Attila Enyedi
- Division of Thoracic Surgery, University of Debrecen, Debrecen, Hungary
| | - Hiran C Fernando
- Department of Surgery, Fairfax Medical Campus, Falls Church, VA, USA
| | - Jozsef Furak
- Department of Surgery, University of Szeged, Szeged, Hungary
| | | | - Carlos Galvez-Munos
- Department of Thoracic Surgery, General University Hospital, Alicante, Spain
| | - Ivo Hanke
- Department of Thoracic Surgery, University Hospital Hradec Kralove, Hradec, Kralov, Czech Republic
| | - Luis A Hernandez-Arenas
- Department of Thoracic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Miroslav Janik
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Peter Juhos
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Lidia Libretti
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Paolo Lucciarini
- Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Paolo Macrì
- Thoracic Surgery Unit, Istituto Clinico Humanitas CCO – Catania, Catania, Italy
| | - Stefano Margaritora
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
| | - Hamid Reza Mahoozi
- Department of Thoracic Surgery, Evangelisches Krankenhaus Herne, Herne, Germany
| | - Dania Nachira
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
| | | | - Vadim Pischik
- Faculty of Medicine, St-Petersburg State University, Saint-Petersburg, Russia
| | - Dariusz Sagan
- Department of Thoracic Surgery, Medical University of Lublin, Lublin, Poland
| | | | | | - Laura Socci
- Thoracic Surgery Units, Sheffield Teaching Hospital, Sheffield, UK
| | - Davide Tosi
- Department of Thoracic Surgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Akif Turna
- Division of Thoracic and Transplant Surgery, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fernando Vannucci
- Department of Thoracic Surgery, Hospital Federal do Andaraí, Rio de Janeiro, Brazil
| | - Marcin Zielinski
- Department of Thoracic Surgery, Pulmonary Hospital, Zakopane, Poland
| | - Gaetano Rocco
- Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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