Novel retractor for lymph node dissection by video-assisted thoracic surgery.

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Video-assisted thoracic surgery (VATS) lobectomy is a recognized treatment for lung cancer.
• Complete mediastinal lymph node dissection can be challenging during VATS due to limited working space.
• Current techniques may require significant retraction of surrounding organs, increasing procedural complexity.

Purpose of the Study:

• To introduce novel instrumentation for improved mediastinal lymph node dissection during VATS.
• To facilitate safer and more efficient "en bloc" lymph node dissection in VATS procedures.
• To overcome the anatomical challenges of deep mediastinal lymph node access in VATS.

Main Methods:

• Development of a specialized retractor to enhance working space within the mediastinum.
• Utilization of endoscopic bipolar forceps for lymph node dissection.
• Integration of instruments with a dedicated electrosurgical generator for bipolar soft coagulation, enabling simultaneous dissection and sealing.

Main Results:

• The developed retractor effectively creates adequate working space for deep mediastinal lymph node access.
• Endoscopic bipolar forceps with soft coagulation allow for precise dissection and sealing of vessels.
• "En bloc" mediastinal lymph node dissection was successfully performed during VATS.

Conclusions:

• The novel instrumentation facilitates improved "en bloc" mediastinal lymph node dissection in VATS.
• This approach enhances the safety and efficacy of VATS lobectomy for lung cancer treatment.
• The developed tools address key limitations in performing complete mediastinal lymph node dissection via VATS.