Management of intraoperative bleeding during minimally-invasive thoracic surgery

Video-assisted thoracic surgery has become the leading surgical approach for thoracic surgery in Asia, as it has previously been the case for many Western countries. Unexpected bleeding during minimally-invasive thoracic surgery may quickly turn into a fatal situation unless a recovery is successfully achieved. The best solution is primarily to avoid critical circumstances by means of preoperative simulation and intraoperative navigation with the implementation of new technologies, i.e., 3D imaging and virtual reality. However, surgeons still need to be prepared for a potential crisis.

This special issue will cover the everlasting theme of intraoperative bleeding. We mainly focused on management of bleeding encountered during minimally-invasive thoracic surgery. We asked expert surgeons from Asia to show how they tackle this problem from their various viewpoints; that is, the different surgical approach, procedure, or infrastructural background. We hope that the knowledge shared by the authors through these manuscripts will enable the readers to achieve the mental and technical preparations necessary in face of a critical intraoperative bleeding. Also, it was of note that the development of effective sealants has eventually led to cases of hemostasis that do not require suturing.

We thank the Journal of Visualized Surgery (JOVS) for providing us a platform for discussing and sharing our experiences on the management of intraoperative bleeding during minimally-invasive thoracic surgery. We also express our sincerest gratitude to all the authors for their contributions to this issue.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Visualized Surgery for the series “Emergency Response to Intraoperative Bleeding”. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jovs.2019.04.01). The series “Emergency Response to Intraoperative Bleeding” was commissioned by the editorial office without any funding or sponsorship. SN and KS served as the unpaid Guest Editors of the series. The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Seshiru Nakazawa

Kimihiro Shimizu