Advertisement

Technique for Complete Video-Assisted Thoracic Lobectomy (c-VATS Lobectomy)

  • Jan SiebengaEmail author
Chapter
  • 2.3k Downloads

Abstract

c-VATS lobectomy (complete video-assisted thoracic surgery) was introduced in the early 1990s. While in the late 1990s and early 2000s, the question was if c-VATS lobectomy is comparable to open lobectomy, the accent has moved to studies which proof that c-VATS lobectomy is better than open lobectomy. Different techniques for performing a c-VATS procedure are described in literature, starting with the technique of simultaneously stapled lobectomy and resulting in complete anatomical resections with lymph node dissection. In this chapter, a straightforward technique is described which dissects from anterior to posterior. The technique is structured and consists of clearly identifiable steps, so it can be used in a training situation for fellows. Lobe-specific pitfalls are discussed.

Keywords

Pulmonary Vein Azygos Vein Left Lower Lobe Inferior Pulmonary Vein Superior Pulmonary Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgement

I would like to thank R. McKenna Jr, M.D., for opening my eyes for the c-VATS lobectomy.

References

  1. 1.
    Baker R, Foote J, Kemmeter P et al (2004) The science of stapling and leaks. Obes Surg 14(10):1290–1298PubMedCrossRefGoogle Scholar
  2. 2.
    Belgers EH, Siebenga J, Bosch AM et al (2010) Complete video-assisted thoracoscopic surgery lobectomy and its learning curve. A single center study introducing the technique in The Netherlands. Interact Cardiovasc Thorac Surg 10(2):176–180PubMedCrossRefGoogle Scholar
  3. 3.
    Craig SR, Walker WS (1995) Potential complications of vascular stapling in thoracoscopic pulmonary resection. Ann Thorac Surg 59(3):736–738PubMedCrossRefGoogle Scholar
  4. 4.
    Gossot D, Merlusca G, Tudor A et al (2009) Pitfalls related to the use of endostaplers during video-assisted thoracic surgery. Surg Endosc 23(1):189–192PubMedCrossRefGoogle Scholar
  5. 5.
    Gottgens KW, Siebenga J, Belgers EH et al (2011) Early removal of the chest tube after complete video-assisted thoracoscopic lobectomies. Eur J Cardiothorac Surg 39(4):575–578PubMedCrossRefGoogle Scholar
  6. 6.
    Handy J, Asaph JW, Douville EC et al (2010) Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy? Eur J Cardiothorac Surg 37(2):451–455PubMedGoogle Scholar
  7. 7.
    McKenna J (2008) Complications and learning curves for video-assisted thoracic surgery lobectomy. Thorac Surg Clin 18(3):275–280PubMedCrossRefGoogle Scholar
  8. 8.
    Nagahiro I, Andou A, Aoe M et al (2001) Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg 72(2):362–365PubMedCrossRefGoogle Scholar
  9. 9.
    Paul S, Altorki NK, Sheng S et al (2010) Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: a propensity-matched analysis from the STS database. J Thorac Cardiovasc Surg 139(2):366–378PubMedCrossRefGoogle Scholar
  10. 10.
    Petersen RP, Pham D, Burfeind WR et al (2007) Thoracoscopic lobectomy facilitates the delivery of chemotherapy after resection for lung cancer. Ann Thorac Surg 83(4):1245–1249PubMedCrossRefGoogle Scholar
  11. 11.
    Ponsky L, Cherullo E, Moinzadeh A et al (2008) The Hem-o-Lok clip is safe for laparoscopic nephrectomy: a multi-institutional review. Urology 71(4):593–596PubMedCrossRefGoogle Scholar
  12. 12.
    Scott WJ, Allen MS, Darling G et al (2010) Video-assisted thoracic surgery versus open lobectomy for lung cancer: a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. J Thorac Cardiovasc Surg 139(4):976–983PubMedCrossRefGoogle Scholar
  13. 13.
    Shigemura N, Akashi A, Funaki S et al (2006) Long-term outcomes after a variety of video-assisted thoracoscopic lobectomy approaches for clinical stage IA lung cancer: a multi-institutional study. J Thorac Cardiovasc Surg 132(3):507–512PubMedCrossRefGoogle Scholar
  14. 14.
    Swanson SJ, Herndon JE, D’Amico TA et al (2007) Video-assisted thoracic surgery lobectomy: report of CALGB 39802 – a prospective, multi-institution feasibility study. J Clin Oncol 25(31):4993–4997PubMedCrossRefGoogle Scholar
  15. 15.
    Watanabe A, Koyanagi T, Ohsawa H et al (2005) Systematic node dissection by VATS is not inferior to that through an open thoracotomy: a comparative clinicopathologic retrospective study. Surgery 138(3):510–517PubMedCrossRefGoogle Scholar
  16. 16.
    Whitson BA, Groth SS, Duval SJ et al (2008) Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg 86(6):2008–2016PubMedCrossRefGoogle Scholar
  17. 17.
    Zhong W, Yang X, Bai J et al (2008) Complete mediastinal lymphadenectomy: the core component of the multidisciplinary therapy in resectable non-small cell lung cancer. Eur J Cardiothorac Surg 34(1):187–195PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Division of Thoracic Surgery, Department of General SurgeryAtrium Medical CentreHeerlenThe Netherlands

Personalised recommendations