Soultanis Constantine Marios, Rivas Diego Gonzalez, Konstantinidis Konstantinos, Siafakas Konstantinos
Department of Thoracic Surgery, 251 Hellenic Airforce General Hospital, Athens, Greece.
Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain.
J Vis Surg. 2017 Apr 10;3:50. doi: 10.21037/jovs.2017.03.02. eCollection 2017.
The shift from open to minimally invasive techniques in thoracic surgery has been dramatic during the past 10 years. Not only the feasibility, safety, reproducibility and oncologic efficacy of these techniques have been clearly demonstrated, but also their superiority concerning mortality, postoperative pain, postoperative quality of life and recovery. Thus, video-assisted thoracic surgery (VATS) is currently the procedure of choice for a wide variety of thoracic interventions, ranging from major pulmonary resections for lung cancer to thymectomy and mediastinal procedures, even to esophageal procedures. Amongst the various minimally invasive techniques, the uniportal or single incision VATS has recently gained great popularity. The concept of a single 2.5 cm incision, despite not being the technique's only advantage, through which major thoracic procedures can be carried out, seems to greatly appeal to surgeons throughout the globe. Appealing as it may be, the technique is also demanding, revealing the need for training. A well organised and structured, fee free training programme that has been running at the Shanghai Pulmonary Hospital for more than 2 years under the inspirational guidance of Dr. Gonzalez Rivas has undoubtedly skyrocketed the technique's adoption worldwide. Of equal significance towards the spread of the technique have proved to be the master classes, 2-day intensive tutorials, hosted by centres all over the world during which Dr Rivas outlines the principles of the technique before performing with the assistance of the local surgical team. We hereby reflect on the experience obtained following Riva's visit to our institution in Athens, Hellas (Greece) for a 2-day uniportal VATS master class, the first held in Hellas.
在过去10年里,胸外科手术从开放手术向微创手术的转变十分显著。这些技术的可行性、安全性、可重复性和肿瘤治疗效果不仅得到了明确证实,而且在死亡率、术后疼痛、术后生活质量和恢复方面也具有优势。因此,电视辅助胸腔镜手术(VATS)目前是各种胸科手术的首选术式,范围从肺癌的大型肺切除到胸腺切除术和纵隔手术,甚至包括食管手术。在各种微创技术中,单孔或单切口VATS最近广受欢迎。仅通过一个2.5厘米的切口就能进行大型胸科手术这一理念,尽管不是该技术的唯一优势,但似乎对全球外科医生极具吸引力。尽管它很有吸引力,但这项技术要求也很高,这表明需要进行培训。在冈萨雷斯·里瓦斯博士的启发指导下,上海肺科医院开展了一项组织有序、结构化且免费的培训项目,该项目运行了两年多,无疑推动了这项技术在全球的应用。对于该技术的推广同样重要的是由世界各地的中心主办的大师班和为期两天的强化教程,在这些活动中,里瓦斯博士在当地手术团队的协助下进行手术演示之前,会概述该技术的原理。在此,我们回顾了里瓦斯访问我们位于希腊雅典的机构举办为期两天的单孔VATS大师班(希腊首次举办)后所获得的经验。