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The Journal of Thoracic and... Jun 2018To highlight some of the legendary figures in the medical field who have paved the path of thoracic surgery today. (Review)
Review
OBJECTIVE
To highlight some of the legendary figures in the medical field who have paved the path of thoracic surgery today.
METHODS
We reviewed historical articles and landmark studies published in anesthesiology, pulmonology, and thoracic surgery, and summarized them as they pertain to current practice.
RESULTS
Throughout our article, we have attempted to chronologically depict how our field has evolved, starting from the development of the stethoscope to reconstructing the esophagus using an extracorporeal tube to minimally invasive complex surgeries that we practice today.
CONCLUSIONS
We hope that our article can inspire the young minds to further grow the field and take it to higher levels.
Topics: History, 15th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Laryngoscopes; Minimally Invasive Surgical Procedures; Respiratory System; Robotic Surgical Procedures; Stethoscopes; Thoracic Surgical Procedures; Thoracoscopes
PubMed: 29501230
DOI: 10.1016/j.jtcvs.2017.12.149 -
Annals of Cardiothoracic Surgery Mar 2023
PubMed: 37035652
DOI: 10.21037/acs-2022-urats-19 -
Journal of Visualized Surgery 2017The popularity of video-assisted thoracic surgery (VATS) which increased worldwide due to the recent innovations in thoracic surgical technics, equipment, electronic...
The popularity of video-assisted thoracic surgery (VATS) which increased worldwide due to the recent innovations in thoracic surgical technics, equipment, electronic devices that carry light and vision and high definition monitors. Uniportal VATS (UVATS) is disseminated widely, creating a drive to develop new techniques and instruments, including new graspers and special staplers with more angulation capacities. During the history of VATS, the classical 10 mm 0° or 30° rigid rod lens system, has been replaced by new thoracoscopes providing a variable angle technology and allowing 0° and 120° range of vision. Besides, the tip of these novel thoracoscopes can be positioned away from the operating side minimize fencing with other thoracoscopic instruments. The curved-tip stapler technology, and better designed endostaplers helped better dissection, precision of control, more secure staple lines. UVATS also contributed to the development of embryonic natural orifice transluminal endoscopic surgery. Three-dimensional VATS systems facilitated faster and more accurate grasping, suturing, and dissection of the tissues by restoring natural 3D vision and the perception of depth. Another innovation in VATS is the energy-based coagulative and tissue fusion technology which may be an alternative to endostaplers.
PubMed: 29078583
DOI: 10.21037/jovs.2017.01.03 -
Current Opinion in Pulmonary Medicine Jul 2014In managing pleural diseases, medical thoracoscopy is often performed as a diagnostic and/or therapeutic procedure, particularly in undiagnosed pleural effusions.... (Comparative Study)
Comparative Study Review
PURPOSE OF REVIEW
In managing pleural diseases, medical thoracoscopy is often performed as a diagnostic and/or therapeutic procedure, particularly in undiagnosed pleural effusions. Flexi-rigid pleuroscopes are now widely available as an alternative to conventional rigid thoracoscopes. There is an ongoing debate on which is the better instrument. This review analyses the current literature that compared rigid and flexi-rigid approaches, and outlines the medical advances that may influence the future role of thoracoscopy.
RECENT FINDINGS
Both rigid and flexi-rigid thoracoscopies are well tolerated. Although biopsies are smaller with flexi-rigid biopsy forceps, two small randomized trials reported similar diagnostic yield using either instrument. No studies have specifically examined patient comfort or the outcome of talc poudrage using the two devices. New techniques (e.g. insulated-tip knife and cryobiopsy) have been used as adjuncts with flexi-rigid pleuroscopy to overcome the difficulties in sampling thickened pleura.
SUMMARY
The rigid and flex-rigid instruments have different merits and limitations. Both approaches provide comparable diagnostic yields in the overall patient population undergoing diagnostic thoracoscopy, though their performances specifically in patients with fibrotic pleural thickening have not been examined. Operators using the flexi-rigid approach should have alternative strategies for sampling thickened pleura. Advances in cytopathology and imaging-guided biopsy will likely reduce the need of medical thoracoscopy in the future.
Topics: Biopsy; Diagnosis, Differential; Equipment Design; Humans; Pleural Effusion; Thoracoscopes; Thoracoscopy
PubMed: 24841076
DOI: 10.1097/MCP.0000000000000059 -
Journal of Thoracic Disease Aug 2021During the last decade, there has been a tremendous effort towards making procedures less invasive, which could reduce complications, decrease hospital stay and minimize... (Review)
Review
During the last decade, there has been a tremendous effort towards making procedures less invasive, which could reduce complications, decrease hospital stay and minimize overall health care cost. Medical thoracoscopy (MT) or pleuroscopy is a minimally invasive procedure commonly performed by interventional pulmonologist in United States. It has a favorable safety profile allowing access to the pleural cavity with a thoracoscope via a small chest wall incision to perform diagnostic or therapeutic interventions under direct visualization. MT allows the physician to perform pleural biopsy with high accuracy, drain loculated pleural effusion, guide chest tube placement and perform pleurodesis. As compared to video-assisted thoracoscopic surgery (VATS), MT is less invasive, does not require single lung ventilation, has a comparable diagnostic yield, and better tolerated in high-risk patients. MT can also be performed at bedside in critically ill patients. Although MT is generally safe, a multi-disciplinary discussion between the interventional pulmonologist, intensive care team, anesthesiologist and thoracic team is necessary to ensure best clinical practice as well as minimize complications for such high-risk patients. The purpose of this article is to review technique, diagnostic and therapeutic indications, as well as contraindications of performing bedside MT in intensive care unit. It aims to review both advantages and limitations of performing MT in intensive care unit.
PubMed: 34527362
DOI: 10.21037/jtd-2019-ipicu-02 -
Journal of Visualized Surgery 2017Video-assisted thoracoscopic surgery (VATS) bronchoplasty is an advanced VATS technique requiring experience in endoscopic sewing, tying and suturing techniques reserved...
Video-assisted thoracoscopic surgery (VATS) bronchoplasty is an advanced VATS technique requiring experience in endoscopic sewing, tying and suturing techniques reserved for cancers arising from central airways. There are three main types of bronchoplasty depending on the extent of cancer involvement of the bronchus. In this paper the author describes his experience with different types of bronchoplasty with case and video illustrations.
PubMed: 29078575
DOI: 10.21037/jovs.2016.12.07 -
Journal of Visualized Surgery 2016The maze procedure is a therapeutic option for selected patients with standalone atrial fibrillation. Advances in ablation technology have made feasible a range of... (Review)
Review
The maze procedure is a therapeutic option for selected patients with standalone atrial fibrillation. Advances in ablation technology have made feasible a range of minimally invasive approaches, avoiding some of the morbidity and technical complexities of the classic maze procedure. Further, combining surgical and transvenous techniques allows a staged approach. We describe the technical aspects of the surgical portion of a staged hybrid approach developed by our group, using a bilateral thoracoscopic-assisted mini-thoracotomy approach with bipolar radiofrequency ablation. In our practice, we have found the minimally invasive bilateral thoracoscopic maze to be a safe and efficacious part of a staged strategy for the treatment of lone atrial fibrillation.
PubMed: 29078520
DOI: 10.21037/jovs.2016.07.19 -
Journal of Visualized Surgery 2016Although the interest for thoracoscopic sublobar resections (TSLR) is rising, its use for treating non-small cell lung carcinoma (NSCLC) is still controversial because... (Review)
Review
Although the interest for thoracoscopic sublobar resections (TSLR) is rising, its use for treating non-small cell lung carcinoma (NSCLC) is still controversial because publications dealing with survival and recurrence rate provide contradictory results. If applied to the resection of lung cancer, thoracoscopic segmentectomies must be performed according to oncological criteria. The aim of this technical paper is to give some technical details on thoracoscopic segmentectomies for the treatment of malignancies. Our experience is based on 235 thoracoscopic anatomical segmentectomies performed in 232 patients for a malignant lesion between January 2007 and July 2016. Indication for segmentectomy was a proven or suspected NSCLC in 184 and suspected metastasis in 51 patients. Intraoperative and postoperative data were recorded in a prospective manner. There were eight conversions into a posterolateral thoracotomy (3.4%) and seven unplanned additional pulmonary resections for an oncological reason (3%). We discuss some technical refinements that could minimize these adverse events and make thoracoscopic segmentectomy a safe and reliable procedure.
PubMed: 29078556
DOI: 10.21037/jovs.2016.10.04 -
The Annals of Thoracic Surgery Dec 2012
Topics: Atrial Appendage; Atrial Fibrillation; Catheter Ablation; Female; Humans; Male; Thoracoscopes; Thoracoscopy
PubMed: 23176906
DOI: 10.1016/j.athoracsur.2012.08.025