演題

IS-9-3

Development of safety and fastness of thoracoscopic surgery for lung resection using multi-angle camera with two cameras and for lung segmentectomy using the PDE imaging system with indocyanine green

[演者] 松本 桂太郎:1
[著者] 山崎 直哉:1, 土谷 智史:1, 宮崎 拓郎:1, 谷口 大輔:1, 永安 武:1
1:長崎大学腫瘍外科

Thoracoscopic surgery (VATS) is riskier with respect to critical complications during the procedure, than endoscopic surgery for other organs. We developed thoracoscopic surgery in the points of safety and fastness. One is thoracoscopic surgery using multi-angle camera with two cameras and another is lung segmentectomy using infrared camera with indocyanine green (ICG).Thoracoscopic surgery using multi-angle camera is named dual-vision thoracoscopic surgery. Three ports (5.5-11.5mm) and one access window (3-4cm) are used for our standard cVATS lobectomy and in this procedure additionally a 0 degree rigid scope with a 5-mm diameter is used, which is inserted through different ports. This allows us to see the operation area from different angles. The advantages of this procedure are viewing the surgical site from multiple angles, viewing the thoracic cavity from a distant perspective to have a wide-angle view, and continuing the operation during cleaning of the main camera. This system could reduce the risks of mistakes by losing view by one-camera method because another camera looks at different area from different direction.Under VATS, it is sometimes difficult to detect the intersegment line. We developed a method to visualize the segment using the PDE imaging system (Hamamatsu Photonics K.K., Japan) or PDD unit (STORZ, Germany). Using these systems with ICG makes it possible to clearly separate the target segment from other areas that show a normal blood flow by eliminating the original blood flow with pulmonary artery ligation. VATS Segmentectomy using this system is very easy, safe, and quick.
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