• Journal of Chest Surgery
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• 제47권3호
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• pp.317-319
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• 2014

Ectopic mediastinal parathyroid adenomas or hyperplasias account for up to 25% of primary hyperparathyroidism cases. Most abnormal parathyroid glands are found in the superior mediastinum within the thymus and can be removed through a cervical incision; however, a few of these glands are not accessible using standard cervical surgical approaches. Surgical resection has traditionally been performed via median sternotomy or thoracotomy. However, recent advancement in video-assisted thoracic surgery techniques has decreased the need for sternotomy or thoracotomy to remove these ectopic parathyroid glands. Here, we report a successful case of video-assisted thoracoscopic removal of a mediastinal parathyroid adenoma.

• Journal of Chest Surgery
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• 제54권4호
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• pp.266-278
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• 2021

Lobectomy is the standard treatment for early non-small cell lung cancer. Various surgical techniques for lobectomy have been developed, and minimally invasive thoracic surgery, such as video-assisted thoracic surgery or robot-assisted thoracic surgery, has been considered as an alternative to conventional open thoracotomy. The recently robotic lobectomy technique has developed since the first case series was published in 2002. Several studies have reported that robotic lobectomy has comparable oncologic and perioperative outcomes to those of video-assisted thoracic surgery lobectomy and open lobectomy. However, robotic lobectomy remains a challenge for surgeons because of the steep learning curve, reduced tactile sensation, difficulty in port placement, and challenges in cooperation between the surgeon and assistant. Many studies have reported on robotic lobectomy, but few have presented surgical techniques for robotic lobectomy. In this article, the surgical techniques and optimal performance of robotic lobectomy are described in detail for all 5 types of lobectomy for surgeons beginning with robotic lobectomy.

• Journal of Chest Surgery
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• 제47권2호
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• pp.197-199
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• 2014

Mediastinal paragangliomas are very rare neuroendocrine tumors. Complete resection is the standard treatment of a paraganglioma because of the tumor's potential malignancy and poor response to chemo- or radiotherapy. However, the highly vascular nature of the tumor and its characteristic anatomic location make complete resection difficult. We report a case of an anterior mediastinal paraganglioma, which was incidentally found on a chest computed tomography scan for chronic cough work-up of a 55-year-old woman. Complete resection was accomplished using video-assisted thoracoscopic surgery, and the patient recovered without any complications.

• Journal of Chest Surgery
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• 제54권4호
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• pp.314-318
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• 2021

In this paper, I present the technique of subxiphoid single-port video-assisted thoracic surgery (VATS) thymectomy for thoracic surgeons to perform this procedure safely. This procedure is indicated for all anterior mediastinal masses and may be extended to lung cancer. The patient is placed in the lithotomy position, and the operator should be on the midline. Below the xiphoid process, a skin incision is made 4-5 cm horizontally at a single thumb's width down. Under two-lung ventilation, CO₂ is insufflated, maintaining 10 mm Hg. The fat tissue and thymic tissue are all resected from the sternum and pericardium between both phrenic nerves using an articulated grasper and an energy device. After retrieval of the mass with a wrap bag, a Jackson-Pratt drain is inserted instead of a chest tube. One of the advantages of this procedure is less postoperative pain than intercostal VATS. The subxiphoid approach can be used for bilateral pneumothorax, bilateral pulmonary metastasectomy, and simple lobectomy for both upper lobes and the right middle lobe.

• Journal of Chest Surgery
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• 제55권5호
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• pp.417-421
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• 2022

Minimally invasive strategies are increasingly popular in patients with myasthenia gravis (MG)-associated thymomas. Within the context of video-assisted thoracoscopic surgery (VATS) as a widely known minimally invasive option, the most recent achievement is uniportal subxiphoid VATS. In MG patients, it is mandatory (1) to minimize perioperative interference with administered anesthetics to avoid complications and (2) to achieve a complete surgical resection, as the prognosis essentially depends on radical tumor resection. In order to fulfill these criteria, we merged this surgical technique with its anesthesiologic counterpart: regional anesthesia with the maintenance of spontaneous ventilation via a laryngeal mask. Non-intubated uniportal subxiphoid VATS for extended thymectomy allowed radical thymectomy in all MG patients with both rapid symptom control and fast recovery.

• Journal of Chest Surgery
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• 제48권5호
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• pp.375-377
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• 2015

We report a case of an entrapped lung after the pectus bar repair of a pectus deformity. The entrapped lung was found incidentally during video-assisted thoracoscopic surgery (VATS) for pneumothorax. Based on VATS exploration, multiple bullae seemed to be the cause of the pneumothorax, but the entrapped lung was suspected to have been a cause of the air leakage.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.447-450
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• 2012

Video-assisted thoracic surgery (VATS) has been recommended as more optimal surgical technique than traditional thoracotomy for lobectomy in lung cancer, but it is not well defined. Here, we compared VATS and traditional thoracotomy based on clinical data. From November 2008 to November 2010, 180 patients underwent lobectomy for non-small-cell lung cancer (NSCL) identified by computerized tomography. Of them, 83 cases were performed with VATS and 97 by thoracotomy. Clinical parameters, consisting of blood loss, operating time, number of lymph node dissection, days of pleural cavity drainage, and length of stay were recorded and evaluated with t test. No significant difference was observed between the VATS and thoracotomy groups in the average intraoperative blood loss, number of lymph node dissections, and days of pleural cavity drainage. While the average operating time in the VATS group was significantly longer than that in thoracotomy group, recurrence was only present in one case, as opposed to 7 cases in the thoracotomy group In conclusion, similar therapeutic effects were demonstrated in VATS and thoracotomy for NSCL. However, VATS lobectomy was associated with fewer complications, recurrence and shorter length of stay.

• Journal of Chest Surgery
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• 제32권8호
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• pp.732-738
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• 1999

배경: 비디오 기술의 발전과 내시경의 향상으로 비디오 흉강경수술은 기흉, 다한증 및 종격동 종양 같은 몇 몇 질환에서는 표준 수술로서 인정받고 있다. 이러한 비디오 흉강경수술은 전신마취하에 이중기도관에 의한 일측 폐환기가 필요하였다. 그러나 폐질환이 동반된 환자나 전신상태가 나쁜 고령의 환자와 같은 고위험군 의 경우는 일측 폐환기나 전신마취 자체에 대한 위험성이 높다. 대상 및 방법: 1997년 12월부터 1998년 7월 까지, 전신상태가 나빠서 전신마취가 위험한 8례의 환자를 대상으로(농흉 6례, 난치성 흉수 1례, 간질성 폐섬 유증 1례) 경막외마취하에 자가호흡을 유지한 상태에서 비디오 흉강경을 이용하여 흉강내 질환의 진단 및 치료를 시행하였다. 결과: 7례에서 성공적으로 비디오 흉강경수술이 시행되었다. 수술 도중 호흡기능이 저하 되어 전신마취로 전환한 경우가 1례 있었으나 개흉술로 전환한 경우는 없었다. 만성 농흉 환자 2례의 경우 에서, 1례는 재발하여 다시 비디오 흉강경 배농술을 시행하였으며 1례는 수술 후 7일째 흉곽성형술을 시행 하였다. 수술시간은 평균 31.8$\pm$15.2분이었으며 수술 후 호흡합병증이 발생한 경우는 없었다. 결론: 경막외마 취하에 비디오 흉강경을 통한 진단 및 치료는 고위험군에서 안전하게 시행될 수 있는 기법이라고 사료된다.

• Journal of Chest Surgery
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• 제33권1호
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• pp.85-87
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• 2000

Patent ductus arteriosus(PDA) is a common congenital heart disease encountered in premature neonates infants and children. Patent ductus arteriosus was the first surgically managed congenital heart disease,. Classic surgical interruption of patent ducturs arteriosus was partially replaced by a transcatheter endovascular closure, After a 5-7 mm video-assisted thoracoscopic interruption of the patent ductus arteriosus first applied in 1991, this minimally invasive technique came to be used in many centers, Video-assisted thoracoscopic interruption of the patent ductus arteriosus is feasible in low-weight infants whereas transcatheter endovascular closure of the ductus is usually not possible. We experienced successful outcome for the treatment of patent ductus arteriosus with 2 mm video-assisted thoracoscopic titanium clipping, We believed that this technique is a simple safe and rapid method for closure of the patent arteriosus.

• Journal of Chest Surgery
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• 제54권4호
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• pp.235-238
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• 2021

The establishment of minimally invasive surgery is a complex and difficult task. Video-assisted thoracic surgery (VATS) refers to a minimally invasive surgical technique that represents a less invasive approach to thoracic surgery using thoracoscopy. For lung cancer or esophageal cancer surgery, planning and establishing a team for minimally invasive surgery for the first time is not a simple task. Technical advances in surgical devices and the enhanced skill of surgeons are cornerstones of the development of minimally invasive surgery. Here, we review the meaning of minimally invasive thoracic surgery and discuss how to establish a team approach for VATS procedures.