The Development of endoscopic thoracic surgery

in thoracic department of 103

hospital

Quang. Pham vinh. PhD. Assisted professor

introduction

• Endoscopic surgery( video- assisted surgery, minimally invasive surgery) was developed very quickly in the early 1990s.

• Since June of 2008, the endoscopic thoracic surgery was developing very quickly in our department.

introduction• Now, we’ve done almost endoscopic thoracic

proceduces in our department, include:

• Diagnostic thoracoscopy for pleural diseases ( empyema thoracis and hemothorax)

• Video-assisted thoracic surgery (VATS) for treatment of parenchymal lung diseases :

- spontaneous pneumothorax

- interstitial lung diseases: pleuropulmonary tuberculosis, localization of pulmonary nodules, wedge resection, anatomic lung resection

introduction

•Video-assisted thoracic surgery (VATS) for diagnosis and treatment of mediastinal diseases :

- mediastinitis- mediastinal masses, cysts,

tumors…- Video - Assisted Video - Assisted

Thoracoscopic Thoracoscopic thymectomy thymectomy - Thoracoscopic thoracic Thoracoscopic thoracic

sympathectomysympathectomy - Thoracoscopic - Thoracoscopic esophagectomyesophagectomy

introduction•Video-assisted thoracic surgery (VATS)

for diagnosis and treatment of chest trauma:

- Hemothorax, persistent hemorrhage, retained hemothorax, clotted blood in the pleura

- Pneumothorax, persistent air leak

- Empyema - Diaphragmatic injuries- Chylothorax- Removal of foreign bodies- Evaluation of heart and great

vessels

introduction

•Video-assisted thoracic surgery (VATS) for diagnosis and treatment of thyroid and breast diseases: −Video-assisted thyroidectomy−Video- assisted breast

lumpectomy

Object and method object

266 patients with diseases of thorax, thyroid gland and breast underwent VATS in thoracic department of 103 hospital from june/2003 - october/2008

Method - Progression and description.

- Examinations:- Indications- Surgical proceduces- Advantages of thoracoscopic

surgery

result and discussionResults of endoscopic thoracic surgery

Diseases (n) (%) results total

good medium bad

Thoracoscopic thoracic Thoracoscopic thoracic sympathectomysympathectomy

160 60.1 156 2 2 160

Primary spontaneous Pneumothorax

12 4.5 12 0 0 12

Empyema 10 3.7 6 3 1 10

Chest trauma 21 7.8 18 3 0 21

Lung 9 3.3 9 0 0 9

Mediastinum 9 3.3 9 0 0 9

Myasthenia gravis 5 1.9 5 0 0 5

Throid gland 20 7.5 20 20

Breast 20 7.5 20 0 0 20

Total 266 100 249(93.6%)

8(3%)

3(1.1)

233(100%)

discussion

Video-assisted thyroidectomy+ Indications + contraIndications

- Cold nodules - Proven malignancy

- Adenoma- Thyroid cysts - Recurrent

intervention- Small goiters

+ Surgical proceduces

- VAT using CO2 to make working space.

- Asst. Pr Quang’s Method:

VAT. Using home - made instrument to make working space and 3 ports are near to the neak

discussionVideo- assisted breast lumpectomy

+ Indications + contraIndications- nodules of the breast - Proven

malignancy - Adenoma of the breast - breast cysts

+ Surgical proceduces

- VAT using CO2 to make working space.

- Asst. Pr Quang’s Method:

VAT. Using home - made instrument to make working space

discussion

Video- assisted for pleural diseases

Indications - Hemothorax, persistent hemorrhage, retained hemothorax, clotted blood in the pleura, Pneumothorax, persistent air leak, Empyema, Diaphragmatic injuries, Chylothorax, Removal of foreign bodies

discussionVideo- assisted for treatment of parenchymal

lung diseases

Indications Pleuropulmonary tuberculosis, localization of pulmonary

nodules, wedge resection, anatomic lung resection

(Video)

discussion

Video- assisted for treatment of Mediastinal diseases

Indications

mediastinitis- mediastinal masses, cysts, tumors, thymectomy thymectomy sympathectomy,sympathectomy, esophagectomyesophagectomy

discussionVideo- assisted for treatment of

chest traumaIndications

- Hemothorax, persistent hemorrhage, retained hemothorax, clotted blood in the pleura

- Pneumothorax, persistent air leak- Empyema - Diaphragmatic injuries- Chylothorax- Removal of foreign bodies- Evaluation of heart and great vessels

conclusion

1. We can apply Endoscopic surgery( video- assisted surgery, minimally invasive surgery) in Hospital 103 very succesfully

2. Advantages of thoracoscopic surgery:

1. Small wound with good view

2 . Useful for the diagnosis of pleural and mediastinal disorders,

as well as for tumors near the lung surface

3. Less pain and good cosmesis

4. Less invasive