[Video-assisted thoracic surgery. Current techniques and indications].
Up til recently, thoracoscopy was essentially performed for diagnostic purposes, allowing biopsies of the pleura or peripheral lesions of the lung tissue. Indications with a therapeutic objective were less frequent, usually in cases of recurrent pneumothorax. The recent development of less aggressive, more surgical instruments has virtually "forced" the surgeon to use the thoracoscope. Video thoracoscopy surgery thus entered the therapeutic armenatum. Small access channels less than a centimeter in diameter are used for videothoracoscopy giving an indirect view on the screed of the thoracic contents. Under these conditions, thoracoscopic procedures are possible to treat pneumothorax and resect small pleural or parenchymatous tumours. Inversely, gross resections (lobectomy, pneumonectomy) are technically more complex and raise the nearly unsolvable problem of removing the surgical specimen. In fact, a mini-thoracotomy has been required in many cases, leading to the development of video-assisted thoracic surgery. This new surgical technique is performed via a small incision and is guided by optic probes connected to the video screen. The surgeon can thus follow the entire operation both directly via the mini-thoracotomy and indirectly on the screen. This new approach is an interesting compromise between conventional thoracic surgery and videothoracoscopy.
Giudicelli
R
R
Unité de Chirurgie thoracique et de Transplantation pulmonaire, Hôpital Sainte-Marguerite, Marseille.
Thomas
P
P
Brunet
C
C
Lonjon
T
T
Reynaud-Gaubert
M
M
Badier
M
M
Ottomani
R
R
Noirclerc
M
M
D006801:Humans; D008168:Lung / Q000601:surgery; D010994:Pleura / Q000601:surgery; D013903:Thoracic Surgery / Q000379:methods; D013906:Thoracoscopy / Q000379:methods; D014741:Video Recording
La chirurgie thoracique vidéo-assistée. Techniques et indications actuelles.