{"title":"Evolution of Video Assisted Thoracoscopic Surgery (VATS) for Thoracic Disc Herniation: Towards Biportal Thoracoscopic approach.","authors":"Víctor Rodrigo,Paula Corral,Miguel Mesa-Guzmán,Valerio Perna,Daniel Rosenthal,Fernández Roque","doi":"10.1016/j.wneu.2024.09.022","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\r\nThis work aims to describe the evolution of the VATS approach from a multiportal access to a biportal access for thoracic herniated disc surgery. Thoracic disc herniation remains a challenging pathology for spine surgeons. Video-Assisted Thoracoscopic Surgery (VATS) of the thoracic spine was described in the 90s and represented an important technical leap by including minimally invasive options for thoracic pathology. Nowadays, VATS in thoracic surgery tends to evolve towards an even less invasive technique, from a multiportal approach to a biportal one.\r\n\r\nMETHODS\r\nWe describe the adoption of this approach for our spinal pathology in three patients. We use a two-port VATS. The largest (approximately 5 cm) with an Alexis retractor ® and a second port (1.5 cm) just for the camera.\r\n\r\nRESULTS\r\nThe three patients started walking in less than 24 hours, and none suffered any complications related to the approach. All of them reported tolerable pain at the surgical site. Changing our previous VATS system from 3 to 5 ports was relatively easy regarding the surgical technique.\r\n\r\nCONCLUSION\r\nThis access allows the surgeon to manipulate the instrumentation confidently, and the camera does not fog up as often. Extracting a piece of rib is unnecessary, and theoretically, we only manipulate one or at most two intercostal nerves, so the patient's recovery is favorable.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.09.022","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
OBJECTIVE
This work aims to describe the evolution of the VATS approach from a multiportal access to a biportal access for thoracic herniated disc surgery. Thoracic disc herniation remains a challenging pathology for spine surgeons. Video-Assisted Thoracoscopic Surgery (VATS) of the thoracic spine was described in the 90s and represented an important technical leap by including minimally invasive options for thoracic pathology. Nowadays, VATS in thoracic surgery tends to evolve towards an even less invasive technique, from a multiportal approach to a biportal one.
METHODS
We describe the adoption of this approach for our spinal pathology in three patients. We use a two-port VATS. The largest (approximately 5 cm) with an Alexis retractor ® and a second port (1.5 cm) just for the camera.
RESULTS
The three patients started walking in less than 24 hours, and none suffered any complications related to the approach. All of them reported tolerable pain at the surgical site. Changing our previous VATS system from 3 to 5 ports was relatively easy regarding the surgical technique.
CONCLUSION
This access allows the surgeon to manipulate the instrumentation confidently, and the camera does not fog up as often. Extracting a piece of rib is unnecessary, and theoretically, we only manipulate one or at most two intercostal nerves, so the patient's recovery is favorable.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS