WordNet

a room where a doctor or dentist can be consulted; "he read the warning in the doctors surgery"
the branch of medical science that treats disease or injury by operative procedures; "he is professor of surgery at the Harvard Medical School"
(sports) the act of enabling another player to make a good play
act as an assistant in a subordinate or supportive function
see ones performance improve; "He levelled the score and then surged ahead"
a sudden or abrupt strong increase; "stimulated a surge of speculation"; "an upsurge of emotion"; "an upsurge in violent crime" (同)upsurge
the visible part of a television transmission; "they could still receive the sound but the picture was gone" (同)picture
(computer science) the appearance of text and graphics on a video display
having help; often used as a combining form (同)aided

PrepTutorEJDIC

〈U〉『外科,』外科医術 / 〈U〉手術 / 〈C〉《英》診察室;〈C〉〈U〉診察時間
〈人〉'を'『手伝う』,助力する,助ける / (…を)『手伝う』,助ける《+『in』(『with』)+『名』(do『ing』)》 / (…に)出席する,立ち会う《+『at』+『名』》
波のように押し寄せる,殺到する / 〈感情が〉こみあげる《+up》 / 急増する,〈株などが〉急騰する / (…が)押し寄せること,(…の)襲来,殺到《+of+名》 / (感情の)高まり,急増,急騰
〈U〉テレビの映像 / 〈C〉テレビ / テレビ映像に関する / ビデオテープの

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/25 22:23:06」(JST)

wiki en

Video-assisted thoracoscopic surgery (VATS) is a type of thoracic surgery performed using a small video camera that is introduced into the patient's chest via a scope. The surgeon is able to view the instruments that are being used along with the anatomy on which the surgeon is operating. The camera and instruments are inserted through separate holes in the chest wall also known as "ports". These small ports are advantageous because the chance for infection and wound dehiscence are drastically reduced. This allows for a faster recovery by the patient and a greater chance for the wound to heal.^[1]

Traditionally, thoracic surgery performed for diagnosis or treatment of chest conditions has required access to the chest through thoracotomy or sternotomy incisions. Sternotomy requires the use of a sternal saw to divide the sternum and requires spreading of the divided portions of the sternum with a sternal retractor to allow for visualization of the thoracic structures, passage of instruments into the chest, and removal of specimens. Thoracotomy, as most commonly performed, requires division of one or more major muscles of the chest wall including the latissimus dorsi, pectoralis or serratus muscles, along with spreading of the ribs with a rib spreader. Because the joints of the ribs with the vertebral bodies have only limited flexibility, the use of a rib spreader usually results in rib fractures in the process of rendering the interspace between the ribs wide enough to perform diagnostic or therapeutic maneuvers. Because of this, thoracic surgeons generally intentionally remove a section of one or more ribs in an effort to prevent splintered rib fractures associated with the use of a rib spreader. Sternotomy and thoracotomy have been proven over decades to provide highly effective means of access to thoracic structures and in general are tolerated by patients. However, both incisions have the potential for causing significant pain that may last for extended periods and both result in bony fractures that require a minimum of six weeks to heal during which time patients must refrain from heavy lifting or strenuous activity. The great advantage of VATS over sternotomy or thoracotomy is avoidance of muscle division and bone fractures that allows for diminished duration and intensity of pain and a shorter time to return to full activity.

VATS came into widespread use beginning in the early 1990s. Operations that traditionally were carried out with thoracotomy or sternotomy that today can be performed with VATS include: biopsy for diagnosis of pulmonary, pleural or mediastinal pathology; decortication for empyema; pleurodesis for recurrent pleural effusions or spontaneous pneumothorax; surgical stapler assisted wedge resection of lung masses; resection of mediastinal or pleural masses; thoracic sympathectomy for hyperhidrosis; operations for diaphragmatic hernias or paralysis; esophageal resection or resection of esophageal masses or diverticula; and VATS lobectomy/mediastinal lymphadenectomy for lung cancer.^[1]

The instrumentation for VATS includes the use of a camera-linked 5mm or 10mm fiber-optic scope, with or without a 30 degree angle of visualization, and either conventional thoracic instruments or laparoscopic instruments. Unlike with laparoscopy, carbon dioxide insufflation is not generally required with VATS due to the inherent vault-like shape of the thoracic cavity. However, lung deflation on the side of the chest where VATS is being performed is a must to be able to visualize and pass instruments into the thorax; this is usually effected with a double-lumen endo-tracheal tube that allows for single lung ventilation or a bronchial blocker delivered via a standard single-lumen endotracheal tube.^[1]

Similarly to laparoscopy, VATS has enjoyed widespread use for technically straightforward operations such as pulmonary decortication, pleurodesis, and lung or pleural biopsies, while more technically demanding operations such as esophageal operations, mediastinal mass resections, or pulmonary lobectomy for early stage lung cancer, have been slower to catch on and have tended to remain confined to selected centers. It is expected that advanced VATS techniques will continue to grow in numbers spurred by patient demand and greater surgeon comfort with the techniques.

References

^ ^a ^b ^c Shields, Thomas (2004). General Thoracic Surgery. Lippincott Williams & Wilkins. pp. 524. ISBN 978-0-7817-3889-7.

Calvin SH Ng, Song Wan, Tak Wai Lee, Innes YP Wan, Ahmed Arifi, Anthony PC Yim. Video-assisted thoracic surgery in spontaneous pneumothorax. Can Respir J 2002;9:122-127 Calvin SH Ng, Song Wan, Tak Wai Lee, Alan DL Sihoe, Innes YP Wan, Ahmed A Arifi, Anthony PC Yim. Video assisted thoracoscopic surgery for mediastinal extramedullary haematopoiesis. Ann R Coll Surg Engl 2002;84:161-163 Calvin SH Ng, Song Wan, Anthony PC Yim. Paradigm shift in surgical approaches to spontaneous pneumothorax: VATS. Thorax 2004;59:357 Calvin SH Ng, Tak Wai Lee, Song Wan, Innes YP Wan, Alan DL Sihoe, Ahmed A Arifi, Anthony PC Yim. Thoracotomy is associated with significantly more profound suppression in Lymphocytes and Natural Killer cells than Video-Assisted Thoracic Surgery following major lung resections for cancer. J Invest Surg 2005;18:81-88 Calvin SH Ng, Tak Wai Lee, Song Wan, Anthony PC Yim. Video-Assisted Thoracic Surgery in the Management of Spontaneous Pneumothorax: The Current Status. Postgrad Med J 2006;82:179-185 Calvin SH Ng, Song Wan, Malcolm J Underwood, Anthony PC Yim. VATS and Extramedullary Haematopoiesis. Eur Resp J 2006;28:255-6 Juan C Garzon, Calvin SH Ng, Alan D Sihoe, Anthony V Manlulu, Randolph HL Wong, Tak Wai Lee, Anthony PC Yim. Video-Assisted Thoracic Surgery Pulmonary Resection for Lung Cancer in Patients with Poor Lung Function. Ann Thorac Surg 2006;81:1996-2003 Calvin SH Ng, Anthony PC Yim. Spontaneous Hemopneumothorax. Curr Opin Pulm Med 2006;12:273-277 Calvin SH Ng, Song Wan, Connie WC Hui, Tak Wai Lee, Malcolm J Underwood, Anthony PC Yim. Video-Assisted Thoracic Surgery for Early Stage Lung Cancer – Can short-term immunological advantages improve long-term survival? Ann Thorac Cardiovasc Surg 2006;12:308-12 Calvin SH Ng, Song Wan, Connie WC Hui, Innes YP Wan, Tak Wai Lee, Malcolm J Underwood, Anthony PC Yim. VATS lobectomy for lung cancer is associated with less immunochemokine disturbances than thoracotomy. Eur J Cardiothorac Surg 2007;31:83-7 Juan C Garzon, Calvin SH Ng, Tak Wai Lee, Anthony PC Yim. Video-assisted Thoracic Surgery for Pneumothorax in LAM. Heart Lung Circ 2007;16: 300-302 Calvin SH Ng, Innes YP Wan, Anthony PC Yim. Impact of Video-Assisted Thoracoscopic Major Lung Resection on Immune Function. Asian Cardiovasc Thorac Annals 2009;17:426-432 Calvin SH Ng, Anthony PC Yim. Videothoracoscopic Approach to Posterior Mediastinal Tumors. Mineo TC (eds). Thoracic Surgery Clinics 2010 May; 20(2):297-309 Calvin SH Ng, Innes YP Wan, Anthony PC Yim. VATS Thymectomy- The Better Approach. Ann Thorac Surg 2010;89: S2135

UpToDate Contents

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1. ビデオ胸腔鏡下手術（VATS）の概要 overview of video assisted thoracoscopic surgery vats
2. 肺転移の外科的切除：利益、適応、術前評価および手技 surgical resection of pulmonary metastases benefits indications preoperative evaluation and techniques
3. 小児における肺炎随伴胸水および膿胸のマネージメントおよび予後 management and prognosis of parapneumonic effusion and empyema in children
4. 成人における原発性自然気胸 primary spontaneous pneumothorax in adults
5. ステージI～II非小細胞肺癌のマネージメント management of stage i and stage ii non small cell lung cancer

English Journal

A microthymoma and no germinal centre in myasthenia gravis.

Hamaji M, Vanderlaan PA, Sugarbaker DJ, McNamee CJ.SourceDivision of Thoracic Surgery, The Brigham and Women's Hospital, Boston, MA, USA.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Dec;44(6):1146-7. doi: 10.1093/ejcts/ezt208. Epub 2013 Apr 15.
A 43-year-old woman with a 1-year history of generalized myasthenia gravis was referred for a video-assisted thorascopic surgery thymectomy. The preoperative chest computed tomography revealed mild diffuse thymic hyperplasia. Pathology of the resected thymus gland revealed a 6-mm World Health Organi
PMID 23588037

Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty: an improved operative technique.

Li Y, Wang J.SourceDepartment of Thoracic Surgery, People's Hospital of Peking University, Beijing, China.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Dec;44(6):1108-12. doi: 10.1093/ejcts/ezt199. Epub 2013 Apr 4.
OBJECTIVES: We summarize our experiences of video-assisted thoracoscopic surgery (VATS) sleeve lobectomy with bronchoplasty for non-small-cell lung cancer and discuss the indications and technical details of the operation.METHODS: From September 2011 to December 2012, 15 patients underwent VATS slee
PMID 23557917

Preoperative computed tomography of the chest in lung cancer patients: the predictive value of calcified lymph nodes for the perioperative outcomes of video-assisted thoracoscopic surgery lobectomy.

Jin KN, Moon HJ, Sung YW, Lee Y, Wi JY.SourceDepartment of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
European radiology.Eur Radiol.2013 Dec;23(12):3278-86. doi: 10.1007/s00330-013-2962-3. Epub 2013 Jul 9.
OBJECTIVES: To determine the predictive value of identifying calcified lymph nodes (LNs) for the perioperative outcomes of video-assisted thoracoscopic surgery (VATS).METHODS: Fifty-six consecutive patients who underwent VATS lobectomy for lung cancer were included. We evaluated the number and locat
PMID 23835925

Japanese Journal

Learning of thoracoscopic radical esophagectomy: How can the learning curve be made short and flat?

Ninomiya Itasu,Osugi Harushi,Tomizawa Naoki,Fujimura Takashi,Kayahara Masato,Takamura Hiroyuki,Fushida Sachio,Oyama Katsunobu,Nakagawara Hisatoshi,Makino Isamu,Ohta Tetsuo
Diseases of the Esophagus 23(8), 618-626, 2011-11
… Attainment of proficiency in video-assisted thoracoscopic radical esophagectomy (VATS) for thoracic esophageal cancer requires much experience. … There were no surgery-related deaths in any of the groups. … Thoracoscopic radical esophagectomy can be mastered quickly and safely with a flat learning curve under the direction of an experienced surgeon. …
NAID 120002772014

急性膿胸に対する治療戦略 : 胸腔鏡手術と術後抗生剤短期投与の検討

椎野王久,坂本和裕,山仲一輝,正津晶子,濱雅史,山川泰,椿原基史
気管支学 : 日本気管支研究会雑誌 33(4), 236-240, 2011-07-25
背景.急性膿胸に対しては胸腔鏡手術(以下VATS)が有用との報告が散見される.一方,術後長期に経口抗生剤が投与されることがあるがその根拠は明らかではない.今回,急性膿胸に対するVATSおよび術後抗生剤の短期投与による再燃の有無を検討した.対象と方法.2005年3月から2010年7月まで急性膿胸に対し当院にてVATSを施行した22例を対象とした.手術は多房化した膿胸腔の単房化と醸膿膜の可及的除去,洗 …
NAID 110008687249

完全鏡視下に摘出した左上縦隔迷入性多発甲状腺腫の1例

奥谷大介,森山重治
日本呼吸器外科学会雑誌 = The journal of the Japanese Association for Chest Surgery
完全鏡視下に摘出した左上縦隔迷入性甲状腺腫の1例を経験したので報告する．症例は55歳男性．健診胸部CTにて異常陰影を指摘された．CTでは腫瘤が気管の後部・食道の左側の上縦隔に存在し，中心部に石灰化を認めた．MRIでは2個の腫瘤が雪ダルマ様に頭尾方向に接するような形で存在しており，いずれも周囲組織との境界は明瞭であり，造影早期より濃染を示した．手術は右側臥位として4ヵ所のポートを設置し，完全鏡視下に …
NAID 10029125860

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