• 国际胸外科专栏 •
Technical aspects of uniportal VATS lung major resections with bronchovascular reconstruction
中华胸部外科电子杂志, 2021,8(4):209-217. DOI:10.3877/cma.j.issn.2095-8773.2021.04.02
摘要

Lung major resections involving bronchovascular reconstruction pose a surgical challenge due to their technical complexity and frequency. The traditional techniques to perform vascular or bronchial reconstructions through multiportal video-assisted thoracoscopic surgery (VATS) approach can be applied also by uniportal VATS approach. Nevertheless, specific tools have already been developed in order to facilitate these procedures through uniportal VATS approach increasing comfort and workspace through the single port utility. These procedures must be performed just in very highly uniportal VATS trained teams and it is recommended that teams who perform these techniques previously have completed the advanced learning curve for lung major resections through uniportal VATS approach. The aim of this paper is to describe the major key points for performing most frequent bronchovascular reconstructions through uniportal VATS approach in a safe and feasible way. Operative technique is step by step described in order to safely perform most common uniportal VATS left/right side lung major bronchovascular resections and reconstructions. Specific tip and tricks are detailed in order to facilitate vascular control, bronchovascular reconstructions and unexpected bleeding control through uniportal VATS approach.

引用本文: SesmaJulio, BoluferSergio, GalvezCarlos, LirioFrancisco, MaféJuanJosé, DelCampoJoneMiren, MarotoSergio, SebastianLeyre, OrtegaMarta, CerezalLuisJorge  Technical aspects of uniportal VATS lung major resections with bronchovascular reconstruction [J/CD] . 中华胸部外科电子杂志, 2021,8(4):209-217. DOI:10.3877/cma.j.issn.2095-8773.2021.04.02
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Video

Video 1 Uniportal video-assisted thoracoscopic surgery (VATS) left upper lobectomy with simple stump bronchotomy and bronchoplasty.
Video 2 Uniportal video-assisted thoracoscopic surgery (VATS) left upper wedge bronchoplasty.
Video 3 Uniportal video-assisted thoracoscopic surgery (VATS) left upper sleeve bronchoplasty.
Video 4 Uniportal video-assisted thoracoscopic surgery (VATS) left intracavitary tourniquets positioning.
Video 5 Uniportal video-assisted thoracoscopic surgery (VATS) unexpected bleeding control with intracavitary tourniquet.
Video 6 Uniportal video-assisted thoracoscopic surgery (VATS) left upper lobectomy with angioplasty of main pulmonary artery.
Video 7 Uniportal video-assisted thoracoscopic surgery (VATS) angiography technique with proximal vascular clamp in order to control unexpected main pulmonary artery bleeding after remove tourniquet.
Video 8 Uniportal video-assisted thoracoscopic surgery (VATS) right upper wedge bronchoplasty.
Video 9 Uniportal video-assisted thoracoscopic surgery (VATS) right lower wedge bronchoplasty.
Video 10 Trick for sleeve procedures: the distal end of running suture is fixed to the endothoracic fascia.
Video 11 Uniportal video-assisted thoracoscopic surgery (VATS) right upper sleeve lobectomy.
Video 12 Uniportal video-assisted thoracoscopic surgery (VATS) right angioplasty with proximal tourniquet and distal intracavitary vascular clamp.
Video 13 Uniportal video-assisted thoracoscopic surgery (VATS) right intrapericardial vascular control of main pulmonary artery.

Authors: Julio Sesma, Sergio Bolufer, Carlos Galvez, Francisco Lirio, Juan José Mafé, Jone Miren Del Campo, Sergio Maroto, Leyre Sebastian, Marta Ortega, Luis Jorge Cerezal
　
　
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