Design variations in vertical muscle-sparing thoracotomy

Mizuno, Tetsuya; Arimura, Takaaki; Kuroda, Hiroaki; Sakao, Yukinori

doi:10.21037/jtd.2018.07.100

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…Moreover, muscle sparing technique and the muscles root re-insertion at the end of the fixation, without section of the muscles fibers, reduces postoperative pain and is associated with a low rate of early/late postoperative complications, as we report also in our study, even if this surgical approach appears to be very invasive (19).…”

Section: Discussionsupporting

confidence: 74%

Prosthetic-free ribs stabilization technique in critical complex chest wall traumas: first results and experiences

2021

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mandatory to significantly reduce early and late respiratory complications (4-6). The timing when to perform a surgical stabilization is not precisely defined, however, it should be performed within the first 72 hours of injury shortening the intensive care unit (ICU) stay, the number of ventilator days and the days under continuous intravenous narcotic medicaments (2,(7)(8)(9)(10)(11)(12). Throughout the years different techniques and materials for surgical fixation have appeared such us metal and absorbable bioprosthetic materials. Absorbable materials seem to have mechanical and clinical advantages compared to metal (easier to customize, no need to remove the prosthesis, stimulation of new bone

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Section: Discussionsupporting

confidence: 74%

Prosthetic-free ribs stabilization technique in critical complex chest wall traumas: first results and experiences

2021

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“…In our practice, OTS is routinely performed using the vertical muscle-sparing/splitting thoracotomy (VMST) [ 4 ] with the operating surgeon standing on the patient’s right side (i.e. patient’s dorsal side during right-lung surgery and ventral side during left-lung surgery), regardless of the side to be operated on.…”

Section: Methodsmentioning

confidence: 99%

“…Similarly, setups such as ‘3/5/8/A6 or A7’ or ‘4/6/8/A6 or A7’ for the right middle lobe, ‘4/6/8/A6 or A7’ for the right lower lobe, ‘3/5/7/A8 or A9’ for the left upper lobe and ‘3/5/8/A9 or A10’ or ‘4/6/8/A9 or A10’ for the left lower lobe were also used. In these setups, 3 robotic ports were placed around the VMST incision line [ 4 ]. Two confronting monitors and 2 assistants were positioned on each side of the patient (Fig.…”

Section: Methodsmentioning

confidence: 99%

Emergency rollout and conversion procedures during the three-arm robotic open-thoracotomy-view approach

Nakada

Shirai

Takahara

et al. 2021

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES To conduct robotic lung resections (RLRs) with views similar to those in open-thoracotomy surgery (OTS), we adopted a vertical port placement and confronting upside-down monitor setting: the robotic open-thoracotomy-view approach (OTVA). We herein discuss the procedures for emergency rollout and conversion from the robotic OTVA to OTS or video-assisted thoracoscopic surgery (VATS). METHODS We retrospectively reviewed the cases of 88 patients who underwent RLR with three-arm OTVA using the da Vinci Xi Surgical System between February 2019 and July 2021. Robotic ports were vertically placed along the axillary line, and 2 confronting monitors and 2 assistants were positioned on each side of the patient. Three possible conversions were prepared: (i) emergency thoracotomy using an incision along the ribs in a critical situation, (ii) cool conversion using vertical incision thoracotomy in a calmer condition and (iii) conversion to confronting VATS. All staff involved in the surgery repeatedly rehearsed the emergency rollout in practice. RESULTS No emergent or cool conversion to OTS occurred. Two patients (2.3%) experienced confronting VATS conversions. One patient underwent an urgent conversion for a moderate haemorrhage from a pulmonary artery branch during left upper lobectomy in the introduction phase. Another patient underwent a calmer conversion during an extended RS6 + S10a segmentectomy, where staples could not be inserted appropriately due to lung lacerations. In all patients, postoperative courses were uneventful. CONCLUSIONS The OTVA setting is a possible option for RLRs. This report describes the emergent rollout and subsequent conversion procedures for this method.

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“…The procedure presented herein provides an appropriate view of the ventral first rib and thoracic outlet as well as the intrathorax, is less invasive and easy to perform, and is, thus, a possible procedural option to resect anterior apical lesions infiltrating into the ventral first rib without severe neurovascular involvement. This method is considered to be a slight modification of the vertical muscle-sparing/splitting thoracotomy (9). Despite the relatively small incision and preservation of most skeletal muscles, the necessary surgical view can be obtained around the anterior thoracic outlet, and the subclavian vein is sufficiently accessible.…”

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confidence: 99%

Resection of an anterior apical tumor invading the ventral first rib: a less invasive lateral thoracotomy approach

Shirai¹,

Nakada²,

Takahashi³

et al. 2022

J Thorac Dis

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Design variations in vertical muscle-sparing thoracotomy

Cited by 8 publications

References 8 publications

Prosthetic-free ribs stabilization technique in critical complex chest wall traumas: first results and experiences

Prosthetic-free ribs stabilization technique in critical complex chest wall traumas: first results and experiences

Emergency rollout and conversion procedures during the three-arm robotic open-thoracotomy-view approach

Resection of an anterior apical tumor invading the ventral first rib: a less invasive lateral thoracotomy approach

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