the development of endoscopic thoracic surgery in thoracic department of 103 hospital quang. pham...
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The Development of endoscopic thoracic surgery
in thoracic department of 103
hospital
Quang. Pham vinh. PhD. Assisted professor
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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.
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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
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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
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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
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introduction
•Video-assisted thoracic surgery (VATS) for diagnosis and treatment of thyroid and breast diseases: −Video-assisted thyroidectomy−Video- assisted breast
lumpectomy
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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
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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%)
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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
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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
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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
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discussionVideo- assisted for treatment of parenchymal
lung diseases
Indications Pleuropulmonary tuberculosis, localization of pulmonary
nodules, wedge resection, anatomic lung resection
(Video)
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discussion
Video- assisted for treatment of Mediastinal diseases
Indications
mediastinitis- mediastinal masses, cysts, tumors, thymectomy thymectomy sympathectomy,sympathectomy, esophagectomyesophagectomy
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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
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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