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surgical intervention video

The optimal treatment of lung cancer invading the chest wall is complete surgical resection via lobectomy and en bloc chest wall resection, which has a 40 to 50% 5-year survival when there is no lymph node involvement. 

VATS lobectomy is currently preferred as a standard approach in selected cases for pulmonary resections, especially for early stage non-small cell lung cancer with acceptable safety, successful surgical outcomes, and oncological efficacy. With recent advances in both equipment and technique, VATS is being applied to more complex conditions by some experienced thoracic surgeons. 

We present the case of a 68-year-old man with pulmonary squamous cells carcinoma of the right upper lobe invading chest wall on the level of posterolateral part of the 3rd and 4th ribs. Right upper lobectomy with en bloc chest wall resection was finally performed by VATS. 



VATS right upper lobectomy with en bloc chest wall resection

VATS右上肺叶切除术，整块胸壁切除


Lobectomía superior derecha por VATS con resección en bloque de la pared torácica


Chirurgie thoracique vidéo-assistée : lobectomie supérieure droite avec résection en bloc de la paroi thoracique


Lobectomia superior direita por VATS com ressecção em bloco da parede torácica


VATS-верхняя лобэктомия справа с en bloc резекцией грудной стенки


全胸腔镜下左肝S9 + 10为磨玻璃影


Торакоскопическая сегментэктомия S9+10 левого легкого по поводу опухоли по типу "матового стекла"


Segmentectomía izquierda total toracoscópica de los segmentos 9 y 10 para opacidad en vidrio esmerilado


Segmentectomia esquerda total toracoscópica dos segmentos 9 e 10 para opacidade em vidro fosco


Segmentectomie gauche S9+10 entièrement thoracoscopique pour une opacité en tesson de bouteille


This video describes the resection of segments 9 and 10 of the left lower lobe using a full thoracoscopic technique without utility incision. 

The patient was an 80-year-old woman in whom a 2cm ground glass opacity was incidentally discovered. Because the nodule was not pure ground-glass opacity (GGO), but had some dense parts, a resection was decided upon. A segmentectomy was preferred because of the patient’s age and the presence of co-morbidities. 

Full thoracoscopic left segmentectomy S9+10 for ground-glass opacity

A 67-year-old otherwise healthy woman presented to her primary care physician with complaints of dyspnea. Her primary care physician obtained a chest X-ray, which revealed a left upper lobe abnormality. A follow-up chest CT revealed a 16mm left upper lobe mass concerning for malignancy in the lingula. A bronchoscopy with brushings was performed and pathology was positive for a well-differentiated adenocarcinoma. As part of a clinical staging, a PET-CT was obtained and demonstrated no FDG avid disease in the thorax or elsewhere. Pulmonary function tests revealed an FEV1 of 2.28 L (122% predicted) and DLCO of 19.05 (112% predicted). The therapeutic objectives were to perform an oncologically sound anatomic lung resection and lymph node dissection for the patients early stage biopsy proven lung cancer. The robotic platform was used in this case and we aimed to demonstrate our approach to a robotic assisted thoracoscopic lingulectomy for lung cancer. 

Robotic assisted thoracoscopic lingulectomy

机器人辅助胸腔镜切除术


Робот-ассистированная торакоскопическая сегментэктомия язычковых сегментов


Lingulectomie thoracoscopique assistée par robot


Lingulectomía toracoscópica asistida por robot


Lingulectomia toracoscópica assistida por robô


Однопортовая торакоскопическая нижняя лобэктомия слева с сегментэктомией язычковых сегментов по поводу бронхэктатической болезни


Lobectomie inférieure gauche thoracoscopique à trocart unique assistée par vidéo et segmentectomie lingulaire pour bronchiectasie


Lobectomia toracoscópica baixa esquerda assistida por vídeo de portal único e segmentectomia lingular para bronquiectasia


单孔电视胸腔镜下左肺叶切除术和肺段切除术治疗支气管扩张症


Lobectomía toracoscópica baja izquierda de puerto único asistida por video y segmentectomía lingular para bronquiectasia


As thoracoscopic surgical techniques are getting increasingly advanced, some thoracic surgeons are dissatisfied with the use of 3 or 4 ports to perform lobectomy. They start to try biportal or uniportal lobectomy in order to make it increasingly less invasive. As compared to 3-portal VATS lobectomy, the literature showed that uniportal VATS lobectomies have even more decreased postoperative pain, without significantly lengthening operative time, increasing blood loss or complications. After acquiring uniportal VATS techniques by adjusting the angle of view, by reorganizing the positions of the instruments, and by updating the anatomical concepts and dissecting process, lobectomy, and even composite-lobe resection, can be managed as a regular procedure. 

We present the case of a 52-year-old man with a left lower lobe and lingular segment bronchiectasis. The patient underwent a left lower lobectomy and lingular segmentectomy using a uniportal video-assisted thoracoscopic approach. 

Uniportal video-assisted thoracoscopic left lower lobectomy and lingular segmentectomy for bronchiectasis

Gastrectomía total laparoscópica para cáncer del cardias Siewert tipo III


Le traitement du cancer du cardia reste un sujet de controverse. La classification communément admise est celle de Siewert qui détermine le type de chirurgie à réaliser sur la base du point de départ de la tumeur. Le type 3 comprend les tumeurs qui se développent entre 2 et 5 cm en-dessous de la ligne Z. Cette localisation est considérée comme un cancer gastrique s’étendant au cardia et doit être traitée par une gastrectomie totale. 

Gastrectomie totale laparoscopique pour cancer du cardia, classification de Siewert type 3

Лапароскопическая гастрэктомия по поводу рака кардии тип III по Siewert


Gastrectomia total laparoscópica para câncer da cárdia Siewert tipo III


腹腔镜全胃切除术治疗SiewertⅢ型贲门癌




The treatment of cancer of the gastric cardia remains a matter of controversy. The widely accepted Siewert classification of gastroesophageal junction adenocarcinomas helps to determine the type of surgery based on the anatomical location of the tumor. Siewert type 3 includes tumors developing between 2 and 5cm underneath the Z line. This location is considered as a gastric cancer which extends to the cardia. It should be treated by means of a total gastrectomy. 

Laparoscopic total gastrectomy for Siewert type III cancer of the cardia

video lecture

In this presentation, Dr. Amer provides an exhaustive overview of minor and major complications related to the video-assisted thoracic approach. 

VATS complications, catastrophes and troubleshooting 

Nesta apresentação, o Dr. Amer propicia um panorama exaustivo das complicações menores e maiores relacionadas à abordagem torácica assistida por vídeo.


Complicações, catástrofes e solução de problemas por VATS

Complications VATS, catastrophes et solutions


Chirurgie thoracique assistée par vidéo : dissection nodale systématique


Realizar uma dissecção linfonodal radical é um ponto-chave para a maioria das ressecções pulmonares maiores para câncer de pulmão.O Dr. Amer destaca os truques técnicos de uma dissecção linfonodal toracoscópica.


Cirurgia torácica assistida por vídeo (VATS): dissecção linfonodal sistemática

Performing a radical lymph node dissection is a key point for most major pulmonary resections for lung cancer. Dr. Amer outlines the technical tricks of a thoracoscopic lymph node dissection. 

Video-assisted thoracic surgery: systematic nodal dissection 

Minimizing air leaks during dissection and opening of the fissure and performing a safe control of vessels require mastering all types of hemostatic tools, including staplers, clips, conventional bipolar, vascular sealing devices, and ultrasonic shears. 

Energy sources for thoracoscopic major pulmonary resections

Minimizar os extravasamentos de ar durante a dissecção e a abertura da fissura e realizar um controle seguro dos vasos exigem o domínio de todos os tipos de ferramentas hemostáticas, incluindo grampeadores, clips, bipolar convencional, dispositivos de selagem de vasos e tesouras ultrassônicas.


Fontes de energia para ressecções pulmonares maiores por toracoscopia

Sources d'énergie pour les résections pulmonaires thoracoscopiques majeures 


As ressecções sublobares são uma nova fronteira da cirurgia toracoscópica.Algumas delas podem ser desafiadoras.O Dr. Gossot destaca os princípios da abordagem totalmente toracoscópica para segmentectomia e discute a experiência do Institut Mutualiste Montsouris (IMM).


Ressecção toracoscópica sublobar

Sublobar resections are a new frontier of thoracoscopic surgery. Some of them can be challenging. Dr. Gossot outlines the principles of the full thoracoscopic approach for segmentectomy and discusses the Institut Mutualiste Montsouris (IMM) experience.

Thoracoscopic sublobar resection

Résection sous-lobaire thoracoscopique


Dr. Walker outlines the benefits of the posterior approach for thoracoscopic lobectomy. A helpful contribution after Dr. Petersen’s presentation about the anterior approach. 

Thoracoscopic lobectomy – posterior approach

Lobectomie thoracoscopique - approche sous-lobaire


O Dr. Walker destaca os benefícios da abordagem posterior para lobectomia toracoscópica.Uma contribuição útil após a apresentação do Dr. Petersen sobre abordagem anterior.


Focus On Video-assisted Thoracoscopic Surgery!