Quang. Pham vinh. PhD. Assisted professor

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Presentation transcript:

Quang. Pham vinh. PhD. Assisted professor The Development of endoscopic thoracic surgery in thoracic department of 103 hospital Quang. Pham vinh. PhD. Assisted professor

introduction Endoscopic surgery( video- assisted surgery, minimally invasive surgery) was developed very quickly in the early 1990s. Since June of 2008, the endoscopic thoracic surgery was developing very quickly in our department.

introduction Now, we’ve done almost endoscopic thoracic proceduces in our department, include: Diagnostic thoracoscopy for pleural diseases ( empyema thoracis and hemothorax) Video-assisted thoracic surgery (VATS) for treatment of parenchymal lung diseases : - spontaneous pneumothorax - interstitial lung diseases: pleuropulmonary tuberculosis, localization of pulmonary nodules, wedge resection, anatomic lung resection

introduction Video-assisted thoracic surgery (VATS) for diagnosis and treatment of mediastinal diseases : - mediastinitis - mediastinal masses, cysts, tumors… - Video - Assisted Thoracoscopic thymectomy - Thoracoscopic thoracic sympathectomy - Thoracoscopic esophagectomy

introduction Video-assisted thoracic surgery (VATS) for diagnosis and treatment of chest trauma: - Hemothorax, persistent hemorrhage, retained hemothorax, clotted blood in the pleura - Pneumothorax, persistent air leak - Empyema - Diaphragmatic injuries - Chylothorax - Removal of foreign bodies - Evaluation of heart and great vessels

introduction Video-assisted thoracic surgery (VATS) for diagnosis and treatment of thyroid and breast diseases: Video-assisted thyroidectomy Video- assisted breast lumpectomy

Object and method object Method 266 patients with diseases of thorax, thyroid gland and breast underwent VATS in thoracic department of 103 hospital from june/2003 - october/2008 Method - Progression and description. - Examinations: - Indications - Surgical proceduces - Advantages of thoracoscopic surgery

Primary spontaneous Pneumothorax result and discussion Results of endoscopic thoracic surgery Diseases (n) (%) results total good medium bad Thoracoscopic thoracic sympathectomy 160 60.1 156 2 Primary spontaneous Pneumothorax 12 4.5 Empyema 10 3.7 6 3 1 Chest trauma 21 7.8 18 Lung 9 3.3 Mediastinum Myasthenia gravis 5 1.9 Throid gland 20 7.5 Breast Total 266 100 249 (93.6%) 8 (3%) (1.1) 233 (100%)

Video-assisted thyroidectomy discussion Video-assisted thyroidectomy + Indications + contraIndications - Cold nodules - Proven malignancy - Adenoma - Thyroid cysts - Recurrent intervention - Small goiters + Surgical proceduces - VAT using CO2 to make working space. - Asst. Pr Quang’s Method: VAT. Using home - made instrument to make working space and 3 ports are near to the neak

Video- assisted breast lumpectomy discussion Video- assisted breast lumpectomy + Indications + contraIndications - nodules of the breast - Proven malignancy - Adenoma of the breast - breast cysts + Surgical proceduces - VAT using CO2 to make working space. - Asst. Pr Quang’s Method: VAT. Using home - made instrument to make working space

Video- assisted for pleural diseases discussion Video- assisted for pleural diseases Indications - Hemothorax, persistent hemorrhage, retained hemothorax, clotted blood in the pleura, Pneumothorax, persistent air leak, Empyema, Diaphragmatic injuries, Chylothorax, Removal of foreign bodies

Video- assisted for treatment of parenchymal lung diseases discussion Video- assisted for treatment of parenchymal lung diseases Indications Pleuropulmonary tuberculosis, localization of pulmonary nodules, wedge resection, anatomic lung resection (Video)

Video- assisted for treatment of discussion mediastinitis- mediastinal masses, cysts, tumors, thymectomy sympathectomy, esophagectomy Video- assisted for treatment of Mediastinal diseases Indications

Video- assisted for treatment of discussion Video- assisted for treatment of chest trauma Indications - Hemothorax, persistent hemorrhage, retained hemothorax, clotted blood in the pleura - Pneumothorax, persistent air leak - Empyema - Diaphragmatic injuries - Chylothorax - Removal of foreign bodies - Evaluation of heart and great vessels

conclusion 1. Small wound with good view 1. We can apply Endoscopic surgery( video- assisted surgery, minimally invasive surgery) in Hospital 103 very succesfully 2. Advantages of thoracoscopic surgery: 1. Small wound with good view 2 . Useful for the diagnosis of pleural and mediastinal disorders, as well as for tumors near the lung surface 3. Less pain and good cosmesis 4. Less invasive