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

2. 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.

3. 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

4. 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

5. 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

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

7. 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/ october/2008
Method
- Progression and description.
- Examinations:
- Indications
- Surgical proceduces
- Advantages of thoracoscopic surgery

8. 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%)

9. 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

10. 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

11. 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

12. 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)

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

14. 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

15. 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