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  • 1
    Electronic Resource
    Electronic Resource
    Cost-containing strategies in video-assisted thoracoscopic surgery (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1198-1200 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Video-assisted thoracoscopic surgery — Cost containment — Patient selection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Video-assisted thoracoscopic surgery (VATS) is now an established approach in the management of many thoracic conditions. However, the high cost of this new technology has deterred many Asian hospitals from widely applying this technique. Methods: This article describes our strategies to reduce cost in our practice of VATS over the last few years. Results: VATS involves (1) careful patient selection, (2) use of conventional thoracic instruments as much as possible, (3) modification of conventional instruments, (4) limited use of expensive consumables, and (5) development and application of endoscopic suturing technique. Conclusions: VATS is still in evolution. Cost containment, while desirable in the West, is a high priority in Asia if this new surgical approach is to be applicable even in developing countries. More research is greatly needed in this area.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900278
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Comparison of two-dimensional vs three-dimensional camera systems in laparoscopic surgery (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 438 -440 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopic surgery — two-dimensional camera system — three-dimensional camera system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The lack of depth perception and spatial orientation in video vision are the drawbacks of laparoscopic surgery. The advent of a three-dimensional camera system enables surgeons to regain binocular vision and may be advantageous in complex laparoscopic procedures. Methods: We prospectively studied two groups of surgeons (with and without experiences in laparoscopic surgery) who performed a designated standardized laparoscopic task using a two-dimensional camera system (Olympus OTV-S4) vs a three-dimensional camera system (Baxter-V. Mueller VS7700) and compared their time performances. Results: The results suggested that only experience in laparoscopic surgery had significant effect on individual's performance. We could not demonstrate any superiority of the 3D system over the 2D system. However, two-thirds of the surgeons commented that the depth perception did improve. Conclusions: With further refinement of the technology, the 3D system may improve its potential in laparoscopic surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900385
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    A case of bronchial obstruction by metastatic renal cell carcinoma (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 855-856 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Bronchial obstruction — Metastatic renal cell carcinoma — Rigid bronchoscopy — Dumon stent
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A 68-year-old Chinese male with a history of renal cell carcinoma presenting with increasing shortness of breath and hemoptysis was found to have subtotal left main bronchial obstruction secondary to a metastatic endobronchial tumor. The mass was completely resected through a rigid ventilating bronchoscope, and a silicone stent was placed over the tumor bed in the left main bronchus. He remained asymptomatic with no evidence of bronchoscopic recurrence 4 months after the procedure. Obstructive endobronchial metastases from nonpulmonary primaries are rare. Endoluminal resection with stent placement can provide good palliation in this group of patients with limited survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900178
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Port-site recurrence following video-assisted thoracoscopic surgery (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 1133-1135 
    Details
    ISSN: 1432-2218
    Keywords: Video-assisted thoracoscopic surgery ; Malignant pleural effusion ; Port-site recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Video-assisted thoracoscopic surgery (VATS) is an established modality in the management of pleural diseases. We report a case of port-site recurrence following management of malignant pleural effusion in an elderly patient with extensive pleural metastasis from adenocarcinoma of the lung. Although her shortness of breath was relieved following VAT decortication and talc insufflation, at 3 months she was found to have a 2.5-cm subcutaneous nodule at the camera port site which on biopsy was confirmed to be metastatic in nature. Even though the nodule was asymptomatic and the patient prognosis was not affected, it is important that both the surgeon and future patients should be aware of this potential complication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00189005
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Video-assisted thoracoscopic management of anterior mediastinal masses (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 1184-1188 
    Details
    ISSN: 1432-2218
    Keywords: Video-assisted thoracoscopic surgery ; Anterior mediastinal masses ; VATS ; Resections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The author reports his personal experience on the management of anterior mediastinal masses using video-assisted thoracoscopic surgery (VATS) at a single institution. From August 1993 to March 1995, 24 patients (14 males and 10 females ranging in age from 9 to 76 years old) with anterior mediastinal masses were diagnosed or treated by VATS. This consisted of 11 biopsies and 13 resections (11 thymectomies and 2 thymic cystectomies). Seven biopsies were performed for primary histological diagnosis (four non-Hodgkin's lymphoma, two metastatic carcinoma, one yolk sac tumor) and four biopsies were performed to detect residual tumors following chemotherapy. Complete thymectomy was accomplished in all 11 cases by examination of the thymic bed and resected specimen. We have reserved this approach for resection of benign masses only. Adequate biopsy for histological diagnosis was obtained in all 11 cases to guide further management. There was no surgical mortality or intraoperative complications. The median postoperative hospital stay for the entire group was 3 days. We conclude that VATS for resection or biopsy of an anterior mediastinal mass is technically feasible and provides an alternative to the conventional approaches in selected patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00210924
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  • 6
    Electronic Resource
    Electronic Resource
    Simultaneous vs staged bilateral video-assisted thoracoscopic surgery (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1029-1030 
    Details
    ISSN: 1432-2218
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. It is generally thought that simultaneous bilateral chest surgery carries a high morbidity. We reviewed the results of simultaneous (under one anesthesia) vs staged bilateral video-assisted thoracoscopic surgery (VATS) from a single institution over a 35-month period. From September 1992 to July 1995, we performed simultaneous bilateral VATS on 37 patients (31 males, six females, age ranging from 15 to 55 years) with spontaneous pneumothorax (20) for bleb resections and pleurodesis; thoracodorsal sympathectomy (12) for palmar hyperhidrosis and vasospastic disease; and metastatic sarcomas (five) for wedge lung resections. During the same period, nine patients with metachronous bilateral spontaneous pneumothorax had staged procedures, as did two with digital ischemic ulcers for sympathectomy and three with metastatic pulmonary osteosarcomas for resection. Mean postoperative hospital stays in days for the simultaneous groups were 3.3 for spontaneous pneumothorax, 2.1 for sympathectomy, and 1.5 for wedge resection, compared to 2.9, 2.5, and 2.2 for the staged groups, respectively (p 〉 0.05 by Mann-Whitney U tests). Likewise, pain assessment by visual analogue scale as well as analgesic requirement showed no significant difference between the simultaneous and the staged groups. We conclude that simultaneous VATS is not associated with increased morbidity or prolonged hospital stay compared to the staged counterparts and provides an attractive alternative to the median sternotomy, bilateral posterolateral thoracotomy, or transternal (clam-shell) thoracotomy for selected cases of simultaneous bilateral lung surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900231
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    A case of bronchial obstruction by metastatic renal cell carcinoma (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 855-856 
    Details
    ISSN: 1432-2218
    Keywords: Bronchial obstruction ; Metastatic renal cell carcinoma ; Rigid bronchoscopy ; Dumon stent
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 68-year-old Chinese male with a history of renal cell carcinoma presenting with increasing shortness of breath and hemoptysis was found to have subtotal left main bronchial obstruction secondary to a metastatic endobronchial tumor. The mass was completely resected through a rigid ventilating bronchoscope, and a silicone stent was placed over the tumor bed in the left main bronchus. He remained asymptomatic with no evidence of bronchoscopic recurrence 4 months after the procedure. Obstructive endobronchial metastases from nonpulmonary primaries are rare. Endoluminal resection with stent placement can provide good palliation in this group of patients with limited survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00189551
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    Paper (German National Licenses)
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  • 8
    Electronic Resource
    Electronic Resource
    Thoracoscopic surgery in the elderly population (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 880-882 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Elderly — Thoracoscopic surgery — VATS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We review our experience in video-assisted thoracoscopic surgery (VATS) on patients over 75 years of age from a single institution. Methods: From September 1992 to November 1995, 22 patients (13 males and 9 females with mean age of 78.1 years) underwent the following procedures: pleural biopsies with or without drainage and decortication (5), drainage of empyema (2), wedge lung biopsy (3), bullectomy and talc insufflation (1), major lung resections (5), mediastinal biopsy (1), pericardiectomy (3), and thymectomy (2). Pulmonary function tests of the entire group showed the mean forced expiratory volume in 1 s (FEV1) to be 1.46 l (range 0.63–2.11) and forced vital capacity (FVC) to be 2.04 (range 0.98–3.55) l. Results: There was no mortality. Morbidity included prolonged chest drainage over 7 days in two patients (9.1%), one of whom was discharged with a drainage bag. Particularly of note was the lack of postoperative pulmonary complications. Conclusions: We conclude that VATS in the elderly population is safe. Age alone should not be a contraindication for major lung or mediastinal surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900188
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  • 9
    Electronic Resource
    Electronic Resource
    Thoracoscopic surgery in the elderly population (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 880-882 
    Details
    ISSN: 1432-2218
    Keywords: Elderly ; Thoracoscopic surgery ; VATS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We review our experience in video-assisted thoracoscopic surgery (VATS) on patients over 75 years of age from a single institution. Methods: From September 1992 to November 1995, 22 patients (13 males and 9 females with mean age of 78.1 years) underwent the following procedures: pleural biopsies with or without drainage and decortication (5), drainage of empyema (2), wedge lung biopsy (3), bullectomy and talc insufflation (1), major lung resections (5), mediastinal biopsy (1), pericardiectomy (3), and thymectomy (2). Pulmonary function tests of the entire group showed the mean forced expiratory volume in 1 s (FEV1) to be 1.46 1 (range 0.63–2.11) and forced vital capacity (FVC) to be 2.04 (range 0.98–3.55) 1. Results: There was no mortality. Morbidity included prolonged chest drainage over 7 days in two patients (9.1%), one of whom was discharged with a drainage bag. Particularly of note was the lack of postoperative pulmonary complications. Conclusions: We conclude that VATS in the elderly population is safe. Age alone should not be a contraindication for major lung or mediastinal surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00188474
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    Paper (German National Licenses)
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  • 10
    Electronic Resource
    Electronic Resource
    Thoracoscopic lobectomy for an infected intrapulmonary bronchogenic cyst (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 439-440 
    Details
    ISSN: 1432-2218
    Keywords: Lobectomy ; Bronchogenic cyst ; Thoracoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 19-year-old male who presented with cough and fever was found to have an 8-cm cyst in his left lung. Video-assisted thoracoscopic left lower lobectomy was performed. The cyst had to be decompressed by needle aspiration prior to retrieval through a 5-cm minithoracotomy. The patient was discharged on postoperative day 4 in good condition. The technical aspects form the basis of this report.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00191636
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