Abstract
Totally endoscopic lobectomies or segmentectomies require the incorporation of different surgical skills and new technologies. Because of the endoscopic vision, with its magnification and unusual viewpoints, anatomical landmarks can be modified. In addition, restricted tissue manipulation and use of endoscopic instruments are disturbing.
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Thoracoscopic Instruments
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Thoracoscopic Haemostatic Devices
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Cost Analysis
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Management of Intraoperative Complications
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Management of Fused Fissures
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Management of the Intersegmental Plane
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3D Reconstruction
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1.1 Electronic Supplementary Material
Examples of scope holders used in our department. a Mechanical (Olympus LTF). b Motorized scope positioner (Viky® EP, EndoControl) (MOV 11610 kb)
Issue related to endoscope soiling (MOV 62952 kb)
Demonstration of the interest of intrathoracic cleaning of the endoscope (EndoClearâ„¢, Virtual Ports) (MOV 45629 kb)
The interest of a blood-deflecting trocar (Delacroix-Chevalier) (MOV 41209 kb)
Needle biopsy of a small nodule for a frozen section (MOV 2933 kb)
Dedicated thoracoscopic instruments allow a sharp dissection to be performed (MOV 28874 kb)
Example of exposure achieved by use of throw-off lung forceps (MOV 7544 kb)
Opening of a tiny and almost complete fissure on the left side, using a vessel-sealing device (MP4 18536 kb)
Opening of a thick and long fissure on the left side. The fissure is shortened by stapling, thus allowing exposure of the posterior mediastinum. A second application of staples can then be done (MOV 56355 kb)
Example of a dangerous conflict between a stapler and a clip (MOV 336864 kb)
Combined use of clips and a vessel-sealing device to control medium-sized vessels (MOV 13073 kb)
Demonstration of the interest of an articulated sealing device for severing pleural adhesions (MOV 4470 kb)
Serious hemorrhage from a tear in a left A6Â artery, with temporary control by packing (MP4 4427 kb)
Example of vascular control using a throw-off bulldog clamp (MP4 9949 kb)
Clamping of the intersegmental plane with help from ventilation during a right S1+2 segmentectomy (MOV 552551 kb)
Selective insufflation of S1 and S2 segments by a direct puncture during a left S1+2 segmentectomy (MOV 50715 kb)
Dissection of the bronchial stump during a right S1+2 segmentectomy to keep it remote from the vessels and the parenchyma (MOV 62496 kb)
Repair of a minor parenchymal tear from a trocar puncture. The stitch is secured by an absorbable clip (Lapra-Ty®, Ethicon) (MOV 15893 kb)
Example of insufficient room for stapling during a right anterior segmentectomy (S3), requiring manual suturing of the segmental bronchus (MOV 128312 kb)
Example of manual suturing during a sleeve middle lobectomy for an intrabronchial carcinoid tumor (running suture with intracorporeal knotting) (MOV 150719 kb)
Example of manual cutting of the bronchial stump and manual suturing during a left upper lobectomy for an intrabronchial carcinoid tumor (interrupted stitches with extracorporeal knotting) (MOV 379595 kb)
Use of a specimen retrieval bag (MOV 65495 kb)
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Gossot, D. (2018). Basics. In: Atlas of Endoscopic Major Pulmonary Resections. Springer, Cham. https://doi.org/10.1007/978-3-319-55901-8_1
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DOI: https://doi.org/10.1007/978-3-319-55901-8_1
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