[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.
Takahashi
Noriyuki
N
Department of Thoracic Surgery, Hokkaido Tomakomai Hospital, Tomakomai, Japan.
Tsunematsu
K
K
Suzuki
A
A
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*