TY - JOUR
T1 - Video-assisted thoracic surgery (VATS) lobectomy
T2 - Focus on technique Raja M. Flores
AU - Flores, Raja M.
PY - 2010/4
Y1 - 2010/4
N2 - Background A clear de?nition of video-assisted thoracic surgery (VATS) lobectomy is lacking in the current peerreviewed literature. Reported cases vary from four to six incisions in number, 4.0 to 10.0 cm in length, and with and without rib spreading; in addition, they include direct visualization through a utility incision. Described is a complete standardized three-incision thoracoscopic technique that maximizes the bene?ts of minimally invasive surgery without compromising oncologic principles. Methods Patients with clinically suspected stage I nonsmall-cell lung cancer (NSCLC) were selected for VATS lobectomy on the basis of thoracic computed tomography. VATS lobectomies were performed using a standardized three-incision technique: a 2-cm camera port, a 2-cm posterior port, and a 4 cm utility incision without rib spreading. Hilar structures were individually ligated, ?ssures were completed, and lymph node dissection was performed entirely under thoracoscopic visualization. Results From May 2002 to December 2009, VATS lobectomy was performed successfully in more than 600 patients at our institution. There were no operative deaths, and the median length of stay was 4 days. Conclusions Standardized VATS lobectomy is feasible, expeditious, and safe. This standardized three-incision technique utilizing a 4-cm utility incision without rib spreading may allow valid comparisons of conventional procedures in clinical trials.
AB - Background A clear de?nition of video-assisted thoracic surgery (VATS) lobectomy is lacking in the current peerreviewed literature. Reported cases vary from four to six incisions in number, 4.0 to 10.0 cm in length, and with and without rib spreading; in addition, they include direct visualization through a utility incision. Described is a complete standardized three-incision thoracoscopic technique that maximizes the bene?ts of minimally invasive surgery without compromising oncologic principles. Methods Patients with clinically suspected stage I nonsmall-cell lung cancer (NSCLC) were selected for VATS lobectomy on the basis of thoracic computed tomography. VATS lobectomies were performed using a standardized three-incision technique: a 2-cm camera port, a 2-cm posterior port, and a 4 cm utility incision without rib spreading. Hilar structures were individually ligated, ?ssures were completed, and lymph node dissection was performed entirely under thoracoscopic visualization. Results From May 2002 to December 2009, VATS lobectomy was performed successfully in more than 600 patients at our institution. There were no operative deaths, and the median length of stay was 4 days. Conclusions Standardized VATS lobectomy is feasible, expeditious, and safe. This standardized three-incision technique utilizing a 4-cm utility incision without rib spreading may allow valid comparisons of conventional procedures in clinical trials.
UR - http://www.scopus.com/inward/record.url?scp=77952426124&partnerID=8YFLogxK
U2 - 10.1007/s00268-009-0340-8
DO - 10.1007/s00268-009-0340-8
M3 - Article
C2 - 20082195
AN - SCOPUS:77952426124
SN - 0364-2313
VL - 34
SP - 616
EP - 620
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 4
ER -