Recently, uniportal video-assisted thoracic surgery (VATS) has developed rapidly and has become the main theme of global surgical development. The specific, standardized and systematic training of this technology has become an important topic. Specific training in the uniportal VATS approach is crucial to ensure safety and radical treatment. Such training approach, including a direct interaction with experienced surgeons in high-volume centers, is crucial and represents an indispensable step. Another form of training that usually occurs after preceptorship is proctorship: an experienced mentor can be invited to a trainee's own center to provide specific on-site tutelage. Videos published online are commonly used as training material. Technology has allowed the use of different models of simulators for training. The most common model is the use of animal wet laboratory training. Other models, however, have been used mostrecently, such as the use of 3D and VR Technology, virtual reality simulators, and completely artificial models of the human thorax with synthetic lung, vessel, airway, and nodal tissues. A short-duration, high-volume, clinical immersion training, and a long term systematic training in high-volume centers are getting more and more attention. According to the evaluation of students' grading, a diversified training mode is adopted and the targeted training in accordance with different students helps to improve the training effect. We have done some work in systematic and standardized training of uniportal VATS in single center. We believe such training is feasible and absolutely necessary.
Humans ; Lung Neoplasms ; surgery ; Surgeons ; education ; Teaching ; Thoracic Surgery, Video-Assisted ; education ; instrumentation ; methods

Minimal invasive surgery with short operation time and enhanced recovery after surgery can truly achieve biological minimal invasiveness. The minimal invasive lung cancer surgery includes several kinds, such as uni-portal video-assisted thoracoscopic surgery (VATS) and multi-portal VATS. Robotic-assisted thoracic surgery (RATS) can be categorized into multi-portal VATS. As a frontier technology of minimal invasive surgical technique, surgical robotic system has been broadly applied in many areas. The average RATS operation time is (91.51±30.80) min among our team, which is much shorter than reported uni-portal VATS operation time. For now, RATS has some drawbacks and is lacking of national practice guidelines, which, we believe, will be solved by technology development and large-scale randomized controlled trials. 
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Humans ; Lung Neoplasms ; surgery ; Minimally Invasive Surgical Procedures ; instrumentation ; methods ; Robotics ; instrumentation ; methods ; Thoracic Surgery, Video-Assisted ; instrumentation ; methods

The aim of this study was to assess whether a 2 mm mini-videothoracoscope could be used as a conventional videothoracoscope in the management of pneumothorax. Thirty patients of ages from 15 to 35 years with recurrent or persistent pneumothorax were involved in this study. The subjects consisted of 27 males and three females. The indications for videothoracoscopic surgery were ipsilateral recurrent pneumothorax in 12 (40%), persistent air leakage in 15 (50%), visible bullae in 2 (6%), and 1 bilateral pneumothorax (3%). The mean operation time was 42.9+/-12.9 min. The average number of uses for Endo-GIA was 1.9+/-1.3 times and chest tube indwelling time was 3.8+/-2.7 days. The average amount of keptoprofen (100 mg/2 mL/ampule) used on the first postoperative day was 1.2+/-1.1 ampules. No parenteral opioids were given to the patients for pain control after the procedures. After a follow up of 8 to 20 months, there was only one recurrence among the patients. In conclusion, a 2 mm videothoracoscope, in selective cases, can be successfully used as conventional videothoracoscope to manage persistent or recurrent pneumothorax with cosmetically excellent results.
Adolescence ; Adult ; Female ; Human ; Male ; Pneumothorax/surgery* ; Recurrence ; Surgical Procedures, Minimally Invasive/methods ; Surgical Procedures, Minimally Invasive/instrumentation ; Thoracic Surgery, Video-Assisted/methods ; Thoracic Surgery, Video-Assisted/instrumentation* ; Thoracoscopes* ; Treatment Outcome

OBJECTIVE: To review the management of NUSS procedure by video-assisted thoracoscopy for the correction of pectus excavatum in 18 patients, and to prevent and treat some complications. METHODS: Eighteen patients with severe pectus excavatum underwent NUSS procedure by video-assisted thoracoscopy from December 2006 to September 2007. RESULTS: The operation time ranged from 30 to 70 min ( average 45 min). Good Results were achieved for all patients after the operation. All of them recovered and were discharged 5 approximately 7 days after the operation. Minor complications occurred in 2 patients. CONCLUSION NUSS procedure is microinvasive and has beautiful outlook with shorter operation time and simple handling.The minimally invasive technique has a low complication rate with satisfactory short-term result. Proper management is important for the recovery at the early postoperative stage.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Funnel Chest ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; instrumentation ; methods ; Thoracic Surgery, Video-Assisted ; methods ; Thoracic Surgical Procedures ; methods ; Thoracoscopy ; methods

The aim of this study was to introduce the experience of diagnosis and treatment for patients with migrated acupuncture needle to pleural cavity and or lung parenchyma. We had treated 5 patients who had acupuncture needles in their thoracic cavity from January 2000 to September 2009. The mean age was 55.8 yr old. All patients suffered from the sequelae of the cerebrovascular accident and had been treated with acupuncture. They had drowsiness and hemiplegic or quadriplegic motor activity. Fever and dyspnea were main symptoms when referred to us. Diagnosis was made by the chest radiography and chest computed tomography which revealed straight metallic materials in their thoracic cavity. The needles were removed via thoracotomy or thoracoscopic procedures. Pleural decortications were also needed in four patients. Thoracoscopic surgery was successfully performed in two patients. After the removal all patients became symptomless. Although we experienced only five patients who have migrated acupuncture needles in thoracic cavity, we suggest that thoracoscopic removal of the needle with or without pleural decortication is the most optimal modality of treatment in those patients.
Acupuncture Therapy/*adverse effects/instrumentation ; Adult ; Aged ; Female ; Foreign-Body Migration/diagnosis/*etiology/*surgery ; Humans ; Male ; Middle Aged ; Needles/*adverse effects ; Pleural Cavity/radiography/surgery ; Radiography, Thoracic ; Retrospective Studies ; Stroke/therapy ; Thoracic Cavity/surgery ; Thoracic Surgery, Video-Assisted ; Thoracotomy ; Tomography, X-Ray Computed

BACKGROUND: Da Vinci Surgical System is one of the greatest inventions of the 20th century, which represents the development direction of the precise minimally invasive surgical techniques, the aim of this study was to comparing the short-term outcomes between da Vinci robot-assisted lobectomy and video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer. METHODS: 45 pairs of non-small cell lung cancer patients underwent pulmonary lobectomy with da Vinci Robotic assisted thoracoscopic (RATS) and VATS approach during the same period from January 2014 to January 2017. The operative time, estimated blood loss (EBL), total number and total groups of dissected lymph nodes, postoperative duration of drainage, the first day volume of drainage, total volume of drainage were compared. RESULTS: No perioperative death and convertion to thoracotomy occured in both groups. There were significant difference between RATS group and VATS group in EBL [(50.30±32.33) mL vs (208.60±132.63) mL], the first day volume of drainage [(275.00±145.42) mL vs (347.60±125.80) mL], the dissected total number [(22.67±9.67) vs (15.51±5.41)] and total team [(6.31±1.43) vs (4.91±1.04)] of lymph node. There were no significant difference in other outcomes. CONCLUSIONS RATS is safe and effective and took better short-outcomes than VATS in non-small cell lung cancer.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; surgery ; Case-Control Studies ; Female ; Humans ; Lung Neoplasms ; surgery ; Lymph Node Excision ; Lymph Nodes ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Operative Time ; Retrospective Studies ; Robotics ; methods ; Thoracic Surgery, Video-Assisted ; instrumentation ; methods ; Thoracoscopy ; instrumentation ; methods

BACKGROUND: Localization of multiple small lung nodules is the technical difficulty of minimally invasive operation resection. However, there are few clinical studies on the preoperative localization of multiple small lung nodules. This study was designed to evaluate the clinical value of preoperative computed tomography (CT) guided microcoil localization for multiple small lung nodules compared with single small lung nodule before video-assisted thoracoscopic surgery (VATS). METHODS: A retrospective analysis of the clinical data of 235 patients with preoperative pulmonary nodules microcoil localization was performed. According to whether the nodules were single, they were divided into single nodule group (184 cases) and multiple nodules group (51 cases) (multiple nodules group). The single nodule group was positioned under CT-guided conventional methods. The multiple nodules group were CT guided localized by microcoil in batches according to priority before VATS. The success rate, complications, pathological results and localization operations related data were statistically analyzed. RESULTS: The success rate of localization in multiple nodule groups was 90.2%, there was no significant difference compared with the single nodule group (90.2% vs 94.6%, P=0.205). The occurrence rate of pneumothorax in multiple nodule group and single nodule group was no statistical difference (21.6% vs 14.1%, P=0.179), however, the operation time in the multiple nodule group was significantly longer than the single nodule group [(30.6±6.6) min vs (19.9±7.4) min, P=0.000]. There were no serious complications such as massive hemoptysis, air embolism or hemothorax. There was no conversion to thoracotomy due to failure of localizing the nodules during operation. Sub-lobectomy was the main method of operation. The majority of postoperative pathologies were non-invasive carcinomas. CONCLUSIONS For multiple small lung pulmonary nodules requiring thoracoscopic surgery, according to certain strategies, preoperative CT-guided localized by microcoil in batches according to priority before VATS is safe and effective, and worthy of promotion.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Multiple Pulmonary Nodules ; diagnostic imaging ; pathology ; surgery ; Preoperative Period ; Retrospective Studies ; Surgery, Computer-Assisted ; Thoracic Surgery, Video-Assisted ; instrumentation ; Tomography, X-Ray Computed ; Treatment Outcome ; Tumor Burden