Özyurtkan Mehmet Oğuzhan, Kaba Erkan, Toker Alper
Department of Thoracic Surgery, Istanbul Bilim University Medical Faculty and Group Florence Nightingale Hospitals, Istanbul, Turkey.
J Vis Surg. 2017 Feb 15;3:20. doi: 10.21037/jovs.2017.01.03. eCollection 2017.
The popularity of video-assisted thoracic surgery (VATS) which increased worldwide due to the recent innovations in thoracic surgical technics, equipment, electronic devices that carry light and vision and high definition monitors. Uniportal VATS (UVATS) is disseminated widely, creating a drive to develop new techniques and instruments, including new graspers and special staplers with more angulation capacities. During the history of VATS, the classical 10 mm 0° or 30° rigid rod lens system, has been replaced by new thoracoscopes providing a variable angle technology and allowing 0° and 120° range of vision. Besides, the tip of these novel thoracoscopes can be positioned away from the operating side minimize fencing with other thoracoscopic instruments. The curved-tip stapler technology, and better designed endostaplers helped better dissection, precision of control, more secure staple lines. UVATS also contributed to the development of embryonic natural orifice transluminal endoscopic surgery. Three-dimensional VATS systems facilitated faster and more accurate grasping, suturing, and dissection of the tissues by restoring natural 3D vision and the perception of depth. Another innovation in VATS is the energy-based coagulative and tissue fusion technology which may be an alternative to endostaplers.
由于胸外科技术、设备、携带光源和影像的电子设备以及高清监视器的最新创新，电视辅助胸腔镜手术（VATS）在全球范围内的普及程度不断提高。单孔VATS（UVATS）广泛传播，推动了新技术和器械的开发，包括新型抓钳和具有更大角度调节能力的特殊吻合器。在VATS的发展历程中，经典的10毫米0°或30°刚性棒状透镜系统已被新型胸腔镜所取代，这些新型胸腔镜提供了可变角度技术，视野范围为0°至120°。此外，这些新型胸腔镜的尖端可以远离手术侧定位，最大限度地减少与其他胸腔镜器械的干扰。弯角吻合器技术以及设计更优的腔内吻合器有助于更好地进行解剖、精确控制和形成更牢固的钉合线。UVATS还推动了胚胎自然腔道内镜手术的发展。三维VATS系统通过恢复自然的三维视觉和深度感知，促进了更快、更准确地抓取、缝合和解剖组织。VATS的另一项创新是基于能量的凝固和组织融合技术，它可能是腔内吻合器的一种替代方法。
