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Videoassistierte Thoraxchirurgie

Eine globale Entwicklung

Video-assisted thoracic surgery

A global development

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Zusammenfassung

Ausgehend von den ersten Versuchen der Thorakoskopie vor über 200 Jahren hat die chirurgische videoassistierte Thorakoskopie (VATS) seit ihrer Einführung vor 25 Jahren rasante Fortschritte gemacht. Durch die weltweite Kooperation und internationale Vernetzung sind Entwicklungen auf allen Kontinenten vorangetrieben worden, die zu einer schonenden Operationstechnik am Thorax geführt haben und damit die Lebensqualität von Patienten und in letzter Konsequenz z. B. die Überlebensraten nach Lungenkrebsoperationen verbessern konnten. Soweit nicht die schiere Größe eines Tumors den minimalinvasiven Zugang verbietet, sind unter onkologisch gleichwertigen Ergebnissen VATS-Eingriffe zu bevorzugen. Der aktuelle Trend geht zum einen in Richtung der Uniportal-VATS, begünstigt durch die Tatsache, dass am Thorax eine Abdichtung bzw. Gasinsufflation nicht erforderlich ist. Zum anderen sind roboterassistierte Eingriffe auf dem Vormarsch. Die Entwicklung, die maßgeblich durch Nordamerika und asiatische Ländern geprägt ist, wird auch in Europa aktiv mit gestaltet. Moderne Medien tragen zur Verbreitung der Methode bei.

Abstract

More than 200 years ago the first attempts at thoracoscopy were made but only after its introduction 25 years ago has video-assisted thoracoscopic surgery (VATS) experienced rapid progress. Due to worldwide cooperation and international networking tremendous progress of the technique was made by thoracic surgeons on all continents developing the technique into a less invasive operating procedure on the thorax. For patients this meant improvement in the quality of life and ultimately better survival rates following lung cancer surgery. The VATS procedures are nowadays the preferred method unless the size and extent of the tumor prohibits a minimally invasive procedure. New trends in VATS are ambulatory, drainless or uniportal VATS, the latter being possible because insufflation of carbon dioxide is not necessary, allowing manipulation with multiple instruments through one small incision. The other trend is robotic-assisted thoracic surgery. The benefits of the robotics are higher degrees of freedom for movement of the instruments. The development of VATS is nowadays a global one with North America and Asian countries being the most active protagonists, but European countries also play an important role in shaping the future of minimally invasive surgery. Modern media help to further promote the technique.

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Authors and Affiliations

  1. Klinik für Thoraxchirurgie, Evangelische Lungenklinik Berlin, Lindenberger Weg 27, 13125, Berlin, Deutschland

    G. Leschber

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Correspondence to G. Leschber.

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G.Leschber gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von der Autorin durchgeführten Studien an Menschen oder Tieren.

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Leschber, G. Videoassistierte Thoraxchirurgie. Chirurg 89, 185–190 (2018). https://doi.org/10.1007/s00104-018-0592-7

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