title: Stepwise approaches to optimize strategy for holding thoracoscope during single port video-assisted thoracoscopic surgery.
abstract: Coordination between the thoracoscope assistant and the surgeon was difficult during single port video-assisted thoracoscopic surgery (SP-VATS). What's more, holding the thoracoscope was an exhausting work for the assistant and optimized strategies were intensely needed. This paper aims to share our experience in making the thoracoscope assistant feel comfortable by illustrating the stepwise approaches in optimizing the strategies for holding the thoracoscope during our practice of SP-VATS. The evolution of techniques were divided into four stages: stage I, traditional 10-mm 30° thoracoscope placed at the posterior part of the incision; stage II, 5-mm thoracoscope towed and fixed via a silk suture; stage III, 5-mm thoracoscope placed outside of a plastic wound protector; stage IV, 5-mm thoracoscope introduced into the thoracic cavity through a 5-mm laparoscopic trocar outside of a plastic wound protector and the assistant stood at a foot-stool. After stepwise improvement, the thoracoscope assistant felt more labor saving and comfortable, and coordination with the surgeon has become smoother.
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Chengwu
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Senyi
authors.initials: S
authors.lastname: Deng
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Liao
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Pu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Mei
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu 610041, China.
authors.forename: Lunxu
authors.initials: L
authors.lastname: Liu
keywords: Video-assisted thoracoscopic surgery (VATS); single port; thoracoscope