[Contrivance for video-assisted thoracic surgery pulmonary resection; a new-shaped rib spreader and one port operatinon].
A new-shaped rib spreader, which was adapted from a ready-made reverse arch rib spreader, was orderd to consist of inverted-Y-shape blades which were 4 cm in length, 3.7 cm in width and bent at 250 angle with each other at the half of length. This rib spreader with long and angled blades make it possible to perform video-assisted thoracic surgery (VATS) lobectomy and segmentectomy with 4-5 cm access incision and only 1 port for almost all of the patients inclusive of a thick chest wall case. A lung grasping forceps and a thoracoscope together were inserted from the same port insicion. The surgeon operates by watching both monitoring vision and direct vision through the access incision. Pulmonary artery (PA) s were ligated by double tied and transfixion suture with silk threads. Pulmonary vein (PV) s and bronchus were stapled and divided with Endo-GIA. Lymph nodes division was performed for ND2a-2b in right side, however, ND2a in left side. These thoracoscopic pulmonay resectional procedure can be performed safely, certainly, cosmeticaly and for reducing cost.
Department of Thoracic Surgery, Hokkaido Tomakomai Hospital, Tomakomai, Japan.
Noriyuki
N
Takahashi
K
K
Tsunematsu
A
A
Suzuki
D017046:Cost Savings; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery; D011013:Pneumonectomy / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000601:surgery; D011667:Pulmonary Veins / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000191:economics / Q000295:instrumentation / Q000379:methods*