First International Symposium, Uniportal VATS—International Course Uniportal VATS, Buenos Aires, Argentina
Introduction
The First International Symposium and the First International Course of Uniportal VATS was held in Buenos Ares, Argentina on August 23rd–25th, 2017.
The visiting experts were Prof. Dr. Diego Gonzalez Rivas (Figure 1) from La Coruña Spain, Prof. Dr. Yuming Zhu (Figure 2) and Dr. Timothy Yang (Figure 3) from Shanghai Pulmonary Hospital, Tongji University.
The Shanghai Pulmonary Hospital is to our knowledge the center with mayor number of mini-invasive surgeries in the world.
Methods
The first day included conferences at UCA University with the international speakers.
Dr. Gustavo Bondulich (Figure 1) presented on the Argentinian experience with Uniportal VATS. Discussion and local academic surgeons participated at the event.
The second day we practiced live surgery from Clinica San Camilo, Bsuenos Aires, Argentina with Dr. Diego Gonzalez Rivas (Figures 4,5), and Tongji University from Shanghai Pulmonary Hospital, China. Drs. Yuming Zhu and Timothy Yang, commented during the surgical procedures two lobectomies and one segmentectomy, with complete lymphadenectomy, were performed in patients with non-small cell lung cancer.
On the last day, Wetlab in Fundación Triada Mininvasiva, Fatima Pilar, to show and learn the technique (Figures 6-8).
Technique (Figure 9)
The patients were placed in full lateral position, with a support under the patient. All procedures were performed under general anesthesia with single lung ventilation. The incision was placed in the 5th intercostal space. There was no rib spreading used. A 10 mm 30 degree scope camera was utilized.
The surgeon and the assistant operated from the front of the patient, allowing access to the vascular structures first. A chest tube K225 was inserted in the incision (2).
Results
Dr. Gaetano Rocco from National Cancer Institute, Italy, used Uniportal VATS for minor procedures, pneumothorax, mediastinal biopsy, pleural effusion and lung wedge resection (3,4).
Uniportal VATS for mayor procedures was introduced in the world by Dr. Diego Gonzalez Rivas, from Coruña University Hospital in Spain.
Lobectomy (5), segmentectomy, pneumonectomy (6,7), bronchoplastic procedures, chest wall resection and lobectomy in non-intubated patient (8,9) were performed.
In Argentina we initially used Uniportal VATS with minor procedures such as lung biopsies, pneumothorax, complicated pleural effusion, pericardial effusion, wedge resection, pleural biopsy, mediastinal biopsy. Later on we treated mediastinal tumors and lung cancer, anatomical segmentectomies and lobectomies with complete lymphadenectomy.
It is important to learn the technique in a step-wise manner.
The keys elements to be able to perform the procedure successfully are, availability of the right instruments, energy medical devices, vascular clips, appropriate stapler, and the skill to use the Uniportal VATS.
Discussion
Thoracic surgeons in Argentina have preferred open surgery for lung cancer. Many of them have used multiport approach for VATS lobectomy.
In our experience we have used open surgery in mayor resection and then we used VATS with multiport approach, 3 ports, then we have attempted 2 ports and finally we have learned and accepted Diego Gonzalez Rivas’s technique (2).
During the event, the local surgeons enjoyed the meeting, the international speakers, the live surgery experience and the Wet lab.
As a matter of fact, this meeting was a great experience for academic surgeons as well as for junior surgeons.
Acknowledgements
Shanghai Pulmonary Hospital, Tongji University; Laboratories Garena, Johnson-Johnson; Medtronic.
Footnote
Conflicts of Interest: The author has no conflicts of interest to declare.
References
- Bondulich GJ. Uniportal VATS in Argentina. Asvide 2018;5:081. Available online: http://asvidett.amegroups.com/article/view/22869
- Bondulich G, Gonzalez Rivas D. Uniportal video-assisted thoracoscopic surgery, Argentinian experience. J Vis Surg 2017;3:60. [Crossref] [PubMed]
- Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg 2004;77:726-8. [Crossref] [PubMed]
- Rocco G, Brunelli A, Jutley R, Salati M, et al. Uniportal VATS for mediastinal nodal diagnosis and staging. Interact Cardiovasc Thorac Surg 2006;5:430-2. [Crossref] [PubMed]
- Gonzalez-Rivas D, de la Torre M, Fernandez R, et al. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg 2011;13:539-41. [Crossref] [PubMed]
- Gonzalez-Rivas D, Mendez L, Delgado M, et al. Uniportal video-assisted thoracoscopic anatomic segmentectomy. J Thorac Dis 2013;5 Suppl 3:S226-33. [PubMed]
- Gonzalez-Rivas D, Delgado M, Fieira E, et al. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg 2014;3:E2. [PubMed]
- Gonzalez-Rivas D, Fieira E, Delgado M, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis 2014;6:641-8. [PubMed]
- Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg 2013;95:426-32. [Crossref] [PubMed]
Cite this article as: Bondulich GJ. First International Symposium, Uniportal VATS—International Course Uniportal VATS, Buenos Aires, Argentina. J Vis Surg 2018;4:34.
