The adequacy of single-incisional thoracoscopic surgery as a first-line endoscopic approach for the management of recurrent primary spontaneous pneumothorax: a retrospective study

Chen, Chih‐Hao; Lee, Shih-Yi; Chang, Ho; Liu, Hung-Chang; Hung, Tzu-Ti; Chen, Chao-Hung

doi:10.1186/1749-8090-7-99

Cited by 21 publications

(15 citation statements)

References 7 publications

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“…The single port access enables the use of a grasping endoscopic instrument, the thoracoscope and an articulated stapler. Surgical instruments entered from different angles could create a three-dimensional working environment (8).…”

Section: Discussionmentioning

confidence: 99%

Uniportal video-assisted thoracic surgery for pneumothorax and blebs/bullae

et al. 2017

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Abstract:The last British Society of Thoracic Surgeons guidelines of 2010 for the management of primary spontaneous pneumothorax (PSP) stated that, after the first recurrence, the treatment of PSP should be a surgical operation, like a bullectomy accompanying with a procedure for inducing pleural adhesions. Therefore, the surgical approach is considered the best treatment to minimise the risk of recurrence in patients who experienced a PSP. There is substantial evidence in the literature demonstrating that the minimally invasive approach should be preferred to the thoracotomic procedure since it can reduce the postoperative pain and it is associated with a faster recovery of the physical and working activity. The video-assisted thoracic surgery (VATS) approach has been shown to offer greater advantages about patient pain and respiratory function when compared to thoracotomic incisions. A single port or single incision or uniportal approach was developed as an alternative to the standard multi-port VATS. Uniportal technique has shown to be safe and efficient not only for pulmonary resections and biopsies but also for lobectomy.When used for PSP, the bullectomy/blebectomy and pleural abrasion/pleurectomy is performed through the single incision through which the chest drain is then inserted. In this perspective, evidence showed that the minimally invasive approach should be preferred, confirming the advantages in comparison with traditional techniques. blebectomy and pleural abrasion/pleurectomy is performed through the single incision through which the chest drain is then inserted (3). In this perspective, evidence showed that the minimally invasive approach should be preferred, confirming the advantages in comparison with traditional techniques (4).Here we described the theoretical aspects of the uniportal VATS approach for PSP. Surgical techniqueUniportal VATS allows performing all the main surgical steps recommended for treating patients affected by PSP with the same clinical advantages of the traditional three-port VATS. The VATS technique achieves the exploration of the chest cavity and the lung parenchyma to find blebs/bullae, to resect the diseased areas of the lung, and to perform adequate pleurodesis procedures (e.g., mechanical parietal pleural abrasion, talc poudrage, pleurectomy, etc.) (2).Patient decubitus is in the lateral position. Otherwise, from the standard three-port VATS approach, where the lesion represents the peak of an ideal pyramid, and the camera and instruments are placed in correspondence of the other three pinnacles, the uniportal VATS technique implies that the target, the thoracoscope, and the instruments all lie in the same sagittal plane. Although the single incision is the fulcrum where the parallel devices reach the target, arranging themselves in a craniocaudal direction (5), the surgeon should be free to move inside the chest cavity without the boundaries due to an unfavourable geometry (6). A 1.5-2 cm skin incision at the sixth intercostal space along the middle axillary line...

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Section: Discussionmentioning

confidence: 99%

Uniportal video-assisted thoracic surgery for pneumothorax and blebs/bullae

et al. 2017

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“…Uniportal VATS (UVATS) is a singleincision thoracoscopic approach. Some evidence suggests that UVATS may improve postoperative pain, paresthesia, and patient satisfaction as compared with traditional VATS [3][4][5][6]. The role of UVATS in performing lobectomy is not well investigated.…”

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confidence: 93%

Total Muscle-Sparing Uniportal Video-Assisted Thoracoscopic Surgery Lobectomy

Tam¹,

Lim²

2013

The Annals of Thoracic Surgery

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“…Since then, some authors have reported SITS for PSP, and the adequacy of the technique has been discussed. [3][4][5][6][7][8][9] We have also established an original SITS procedure with a single incision 2.0 cm in length and have been using it in PSP patients since 2009. We herein describe the clinical characteristics and surgical results for the first 100 patients who underwent SITS for PSP.…”

Section: Introductionmentioning

confidence: 99%