• Title/Summary/Keyword: Operation technique

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Early and Midterm Results of Hybrid Endovascular Repair for Thoracic Aortic Disease (흉부대동맥 질환에서 시행된 하이브리드 혈관내 성형술의 중단기 성적)

  • Youn, Young-Nam;Kim, Kwan-Wook;Hong, Soon-Chang;Lee, Sak;Chang, Byung-Chul;Song, Seung-Jun
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.490-498
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    • 2010
  • Background: A hybrid procedure using an open surgical extra-anatomic bypass of aortic arch vessels and thoracic endovascular aortic repair (TEVAR) is less invasive than open surgery, and provides a suitable proximal landing zone. Here we report our experience with a hybrid TEVAR procedure at a single center. Material and Method: We retrospectively reviewed consecutive patients with thoracic aortic disease who received a hybrid TEVAR procedure between August 2008 and January 2010. Patients' data were prospectively collected and mean follow-up was $10.8{\pm}5.5$ months (range 3~20). Result: Nine patients (7 males and 2 females) with a mean age of $63.8{\pm}15.8$ years (range 38~84) underwent a hybrid procedure. Five patients had an arch or a proximal descending aortic aneurysm, two had a dissecting aneurysm of the descending aorta, and two had an aneurysm of the ascending arch and descending aorta. Mean expected mortality calculated by logistic EuroSCORE was 21%. Six patients underwent debranching and rerouting from ascending aorta to arch vessels, 2 had carotid-carotid bypass grafting, and 1 underwent carotid-axillary bypass grafting. Mean operation time was $221.4{\pm}84.0$ min (range 94~364). Deployment success of endovascular stent grafting was 100% with no endoleak on completion angiography. There was no mortality, and a small embolism in the branch of the right opthalmic artery in one patient. During follow-up, one intervention was required for the endoleak. Actuarial survival at 20 months was 100%. Conclusion: Early and mid-term results are encouraging and suggest that hybrid TEVAR procedures are less invasive and safer and represent an effective technique for treating thoracic aortic disease.

A Study on Needs of the Families of Head Injury Patients (두부 손상환자 가족의 간호요구에 대한 연구)

  • Cho Gyoo-Yeong;Park Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.414-433
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    • 1999
  • The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

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Low Volume Peritoneal Dialysis in Newborns and Infants (신생아와 영아의 급성신부전증 치료를 위한 저용량 복막투석)

  • Park, Young-Hoon;Ahn, Soo-Ho;Shin, Son-Moon;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.128-137
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    • 1991
  • Peritoneal dialysis has been widely considered to be the dialytic treatment of choice for acute renal failure in infants and young children, because the technique is simple, safe and easily adapted for these patients. Also peritoneal dialysis in infants might have more effective ultrafiltration and clearance than in adults. In certain circumstances associated with hemodynamic instability, ordinary volume peritoneal dialysis(30-50 ml/kg body weight per exchange) or hemodialysis may not be suitable unfortunately. But frequent cycled, low volume, high concentration peritoneal dialysis may be more available to manage the hemodynamically untable acute renal failure of newborns and infants. Seven infants underwent peritoneal dialysis for hemodynamically unstable acute renal failure with low exchange volume($14.2{\pm}4.2ml/kg$), short exchange time(30 to 45 minutes) and hypertonic glucose solution(4.25% dextrose). Age was $1.9{\pm}1.3$ months and body weight was $4.6{\pm}1.6kg $. Etiology of acute renal failure was secondary to sepsis with or without shock(5 cases) and postcardiac operation(2 cases). Catheter was inserted percutaneously with pigtail catheter or Tenkhoff catheter by Seldinger method. Dialysate was commercially obtained Peritosol which contained sodium, chloride, potassium, magnesium, lactate and calcium. Net ultrafiltration(ml/min) showed no difference between low volume dialysis and control($0.27{\pm}0.09$ versus $0.29{\pm}0.09$) Blood BUN decreased from $95.7{\pm}37.5$ to $75.7{\pm}25.9mg/dl$ and blood pH increased from $7.122{\pm}0.048$ to $7.326{\pm}0.063$ after 24 hours of peritoneal dialysis. We experienced hyperglycemia which were controlled by insulin(2 episodes), leakage at the exit site(2), mild hyponatremia(1) and Escherichia coli peritonitis(1). Two children of low volume dialysis died despite the treatment. In our experience, low volume and high concentration peritoneal dialysis with frequent exchange may have sufficient ultrafiltration and clearance without significant complications in the certain risked acute renal failure of infants.

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Development of the evaluation tool for the food safety and nutrition management education projects targeting the middle class elderly: Application of the balanced score card and the structure-process-outcome concept (중산층 노인대상 식품안전·영양관리 교육 사업 평가를 위한 도구 개발: 균형성과표와 구조·과정·성과 개념 적용)

  • Chang, Hyeja;Yoo, Hyoi;Chung, Harim;Lee, Hyesang;Lee, Minjune;Lee, Kyungeun;Yoo, Changhee;Choi, Junghwa;Lee, Nayoung;Kwak, Tongkyung
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.542-557
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    • 2015
  • Purpose: The aim of this study is to develop an evaluation tool for operation of food safety and nutrition education projects for middle class elderly using the concept of the balanced score card. Methods: After the draft of the evaluation tool for the elderly training projects was completed, it was revised into the questionnaire and the validity of the indicators was tested by the Delphi group. The validity of the indicators was rated using a 5-point scale. The Delphi group consisted of 26 experts in the education sector, 16 government officials, and 24 professionals of the related area in communities. The first round test was conducted from July 9 to July 17, 2012, and 45 persons responded. The second round test was conducted from July 18 to July 25 and 32 persons responded. Results: The indicators, which were answered by more than 75 percent of the experts as 'agree' (4 points), 'strongly agree' (5 point) were included as the final indicators for the evaluation tool: 28 items out of 36 in outcome perspectives, 9 items out of 12 in process perspectives, and 17 out of 20 items in structure perspectives. The score was allocated as 50 points for outcome indicators, 20 points for process indicators, and 30 points for structure indicators. Conclusion: Completion of the evaluation tool is a prerequisite to determine whether the program is effectively implemented. The monitoring tool developed in the study could be applied for identification of the most optimal delivery path for the food safety and nutrition education program, for the spread of the food safety and nutrition education program for middle class elderly.

Study for making movie poster applied Augmented Reality (증강현실 영화포스터 제작연구)

  • Lee, Ki Ho
    • Cartoon and Animation Studies
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    • s.48
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    • pp.359-383
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    • 2017
  • 3,000 years ago, since the first poster of humanity appeared in Egypt, the invention of printing technique and the development of civilization have accelerated the poster production technology. In keeping with this, the expression of poster has also been developed as an attempt to express artistic sensibility in a simple arrangement of characters, and now it has become an art form that has become a domain of professional designers. However, the technological development in the expression of poster is keep staying in two-dimensional, and is dependent on printing only that it is irrelevant to the change of ICT environment based on modern multimedia. Especially, among the many kinds of posters, the style of movie posters, which are the only objects for video, are still printed on paper, and many attempts have been made so far, but the movie industry still does not consider ICT integration at all. This study started with the feature that the object of the movie poster dealt with the video and attempted to introduce the augmented reality to apply the dynamic image of the movie to the static poster. In the graduation work of the media design major of a university in Korea, the poster of each works for promoting the visual work of the students was designed and printed in the form of a commercial film poster. Among them, 6 artworks that are considered to be suitable for augmented reality were selected and augmented reality was introduced and exhibited. Content that appears matched to the poster through the mobile device is reproduced on a poster of a scene of the video, but the text informations of the original poster are kept as they are, so that is able to build a moving poster looked like a wanted from the movie "Harry Potter". In order to produce this augmented reality poster, we applied augmented reality to posters of existing commercial films produced in two different formats, and found a way to increase the characteristics of AR contents. Through this, we were able to understand poster design suitable for AR representation, and technical expression for stable operation of augmented reality can be summarized in the matching process of augmented reality contents production.

The new explore of the animated content using OculusVR - Focusing on the VR platform and killer content - (오큘러스 VR (Oculus VR)를 이용한 애니메이션 콘텐츠의 새로운 모색 - VR 플랫폼과 킬러콘텐츠를 중심으로 -)

  • Lee, Jong-Han
    • Cartoon and Animation Studies
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    • s.45
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    • pp.197-214
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    • 2016
  • Augmented Reality, virtual reality in recently attracted attention throughout the world. and Mix them mixed reality etc., it has had a significant impact on the overall pop culture beyond the scope of science and technology. The world's leading IT company : Google, Apple, Samsung, Microsoft, Sony, LG is focusing on development of AR, VR technology for the public. The many large and small companies developed VR hardware, VR software, VR content. It does not look that makes a human a human operation in the cognitive experience of certain places or situations or invisible through Specific platforms or program is Encompass a common technique that a realization of the virtual space. In particular, out of the three-dimensional image reveals the limitations of the conventional two-dimensional structure - 180, 360 degree images provided by the subjective and objective symptoms such as vision and sense of time and got participants to select it. VR technology that can significantly induce the commitment and participation is Industry as well as to the general public which leads to the attention of colostrum. It was introduced more than 10 related VR works Year 2015 Sundance Film Festival New Frontier program. The appearance VR content : medical, architecture, shopping, movies, animations. Also, 360 individuals can be produced by the camera / video sharing VR is becoming an interactive tunnel between two possible users. Nevertheless, This confusion of values, moral degeneration and the realization of a virtual space that has been pointed out that the inherent. 4K or HUD, location tracking, motion sensors, processing power, and superior 3D graphics, touch, smell, 4D technology, 3D audio technology - It developed more than ever and possible approaches to reality. Thereafter, This is because the moral degeneration, identity, generational conflict, and escapism concerns. Animation is also seeking costs in this category Reality. Despite the similarities rather it has that image, and may be the reason that the animation is pushed back to the VR content creation. However, it is focused on the game and VR technology and the platform that is entertaining, but also seek new points within the animation staying in the flat Given that eventually consist of visual images is clear that VR sought. Finally, What is the reality created in the virtual space using VR technology could be applied to the animation? So it can be seen that the common interest is research on what methods and means applied.

Clinical and Radiographic Outcome of Shoulder Function after Unreamed Antegrade Intramedullary Nailing for Humerus Fracture: Ultrasonographic Evaluation for Rotator Cuff Integrity (비확공성 전향적 상완골 금속정 고정술후 견관절 기능에 대한 임상적 및 방사선학적 평가: 초음파를 이용한 회전근 개 추시관찰)

  • Baek, Seung-Hoon;Choi, Chang-Hyuk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.1
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    • pp.1-9
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    • 2013
  • Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.

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Immunoelectron Microscopic Study on the Paneth Cell of Rabbit after the Common Bile Duct Ligation (총담관결찰후 집토끼 Paneth세포의 변화에 대한 면역전자현미경적 연구)

  • Park, Kyung-Ho;Cho, Hwee-Dong;Yang, Nam-Gil;Ahn, E-Tay;Ko, Jeong-Sik;Kim, Jin-Gook
    • Applied Microscopy
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    • v.24 no.2
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    • pp.78-92
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    • 1994
  • Lysozyme has been reported to be present in the secretory granules of the Paneth cell, and lysozyme immunoreactivity has been detected by immunogold method in Paneth cells of the intestine of human, mouse and rat. The present study was aimed at clarifying the intracellular distribution and changes of the lysozyme immunoreactivity in rabbit Paneth cell after common bile duct ligation of rabbit, using the electron microscope immunogold technique. Healthy adult rabbits weighing about 2kg body weight were divided into normal and bile duct ligated groups. Common bile duct ligation was performed aseptically under ether anesthesia. Experimental animals were sacrificed on the 1st, the 3rd, the 5th, the 7th and the 14th day after the operation. Mucosal specimens from the intestinal gland of ileum were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde, followed by 1% osmium tetroxide, embedded in araldite mixture, cut with LKB-V ultratome. Ultrathin sections were placed on parlodion coated nickel grids (200mesh). The section-bearing grids were floated upside down on the added substance in a moist chamber at room temperature except for the primary antibody step, which was at $4^{\circ}C$. Sections were etched with a saturated solution of sodium m-periodate for 60min. After etching, sections were pretreated with 0.02M tris buffered saline (TBS), pH 8.4, with 1% bovine serum albumin (BSA, Sigma) for 60min, then treated polyclonal rabbit anti-human lysozyme (Dakipatts) diluted 1 : 50 in TBS with 0.1% BSA for 20hr. Subsequently, grids were incubated 60min in biotinylated goat anti rabbit IgG (Amersham) diluted 1 : 100 in TBS with 0.1% BSA. After this, sections were incubated 60min on streptavidin gold G10 (Amersham) diluted 1 : 50 in TBS with 0.1% BSA. After each step, the grids were briefly rinsed with TBS with 0.1% BSA. After the strepavidin gold step, the sections were jet washed with distilled water. Counterstain of the sections performed by uranyl acetate and lead citrate, and observed with JEM 100 CX II electron microscope. Observed results were as follow; 1. Secretory granules of mouse Paneth cells have a lysozyme immunoreactivity and also eosinophil leucocyte of rabbit applied for the positive-control stain, are well labeld with gold particles. 2. Normal rabbit Paneth cells have a lysozyme immunoreactivity restricted on the secretory granules. 3. Amount lysosomes containing myelin figures in the Paneth cells were significantly increased from 5th day after the common bile duct ligation. 4. Immunoreactivity of Paneth cell secretory granules were more activated on the 3rd day after the common bile duct ligation as compared with those of the normal animal. But the lysozyme immunoreactivity were decreased from the 5th day after the common bile duct ligation. 5. Considering the above finding, lysozyme contained Paneth cell are affected following of common bile duct ligation, whereas lysosomes containing myelin-figure do not exhibit any immunoreactive relationship with those of secretory granules.

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A Basie Health Survey of the Yonsei Community Health Service Area, Seoul (연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査))

  • Yang, Jae-Mo;Kim, Myung-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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The Safety and Usefulness of Combined Video-Assisted Mediastinoscopic Lymph Adenectomy and Video-Assisted Thoracic Surgery Lobectomy for Left-sided Lung Cancer (좌측 폐암 환자에서 동반 시행한 비디오 종격동경 림프절 절제술과 흉강경 폐엽 절제술의 안정성과 유용성)

  • Jung, Hee Suk;Kim, Yong Hee;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.33-38
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    • 2010
  • Background: The use of video-assisted thoracic surgery (VATS) to perform major pulmonary resection with systematic node dissection (SND) for lung cancer by is commonly used in clinics. However, the feasibility of SND by VATS remains controversial. Video-assisted mediastinal lymphadenectomy (VAMLA) increases the quality of mediastinal lymph node staging in lung cancer. The video-mediastinoscope allows systematic lymphadenectomy by bimanual preparation. This study was conducted to assess safety and usefulness and clinical feasibility of VAMLA expanding Linder-Dahan mediastinoscope with VATS lobectomy for left sided lung cancer. Material and Method: Between February 2004 to April 2008, a total 50 patients who underwent VATS lobectomy for left sided lung cancer were analyzed retrospectively. Thirty patients (group A) underwent VAMLA followed by VATS lymphadenectomy and 20 patients (group B) underwent VATS lymphadenectomy for SND. Result: There were no statistical differences in operation times, chest tube indwelling times, or hospital days between the 2 groups. The number of dissected total nodes (p=0.001) and N2 nodes (p=0.013) were higher in group A than in group B, but there was no difference in N1 nodes. Postoperative complications included 2 prolonged air leakages (${\geq}$10 days) in each group, one pneumonia in group A, and one vocal cord palsy in group B. There were no early operative mortalities. Conclusion: Mediastinal staging of resectable lung cancer is performed by VAMLA. This new technique is the basis for VATS lobectomy particularly for left-sided lung cancer, because a higher percentage of mediastinal lymph nodes undergo complete resection using VAMLA.