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三维电视辅助胸腔镜手术(3D-VATS)用于肺切除的可行性。

Feasibility of 3-dimensional video-assisted thoracic surgery (3D-VATS) for pulmonary resection.

作者信息

Dickhoff Chris, Li Wilson W, Symersky Petr, Hartemink Koen J

机构信息

Department of Cardio-Thoracic Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands ; Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.

Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands.

出版信息

Ann Surg Innov Res. 2015 Oct 15;9:8. doi: 10.1186/s13022-015-0018-x. eCollection 2015.

Abstract

BACKGROUND

Two-dimensional video-assisted thoracic surgery (2D-VATS) has gained its position in daily practise. Although very useful, its two-dimensional view has its drawbacks when performing pulmonary resections. We report our first experience with 3-dimensional video-assisted surgery (3D-VATS). Advantages and differences with 2D-VATS and robotic surgery (RS) are discussed.

METHODS

To evaluate feasibility, we scheduled patients for surgery by 3D-VATS who would normally be treated with 2D-VATS. The main difference of the equipment in 3D-VATS compared with former VATS equipment, is the flexible camera-tip (100-degrees) and the necessary 3D-glasses.

RESULTS

Four patients were successfully operated for anatomic pulmonary resections. On-the-structure dissection was easily performed and with the flexible camera-tip, a perfect view can be obtained, with clear visualisation of important (hilar) structures. These features highly facilitate the surgeon in tissue preparation and recognition of the dissection planes.

CONCLUSION

In our opinion, 3D-VATS is superior to 2D-VATS for performing anatomic pulmonary resection and we expect an improvement in terms of operation time and learning curve. Furthermore, it is a valuable alternative for RS at lower costs.

摘要

背景

二维电视辅助胸腔镜手术(2D-VATS)已在日常实践中占据一席之地。尽管它非常有用,但在进行肺切除手术时,其二维视野存在缺陷。我们报告了我们首次使用三维电视辅助手术(3D-VATS)的经验。并讨论了3D-VATS与2D-VATS及机器人手术(RS)相比的优势和差异。

方法

为评估可行性,我们安排通常接受2D-VATS治疗的患者接受3D-VATS手术。与以前的VATS设备相比,3D-VATS设备的主要区别在于灵活的摄像头尖端(100度)和所需的3D眼镜。

结果

4例患者成功接受了解剖性肺切除术。在结构上的解剖操作很容易进行,借助灵活的摄像头尖端,可以获得完美的视野,清晰显示重要的(肺门)结构。这些特征极大地便于外科医生进行组织准备和识别解剖平面。

结论

我们认为,在进行解剖性肺切除方面,3D-VATS优于2D-VATS,我们预计在手术时间和学习曲线方面会有所改善。此外,它是一种成本较低的RS的有价值替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85f3/4608051/fa4cbecf8571/13022_2015_18_Fig1_HTML.jpg

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