Crossing the bridge to VATS lobectomy.

Area of Science:

• Thoracic Surgery
• Surgical Education
• Minimally Invasive Procedures

Background:

• Video-assisted thoracoscopic surgery (VATS) lobectomy has been available for 20 years.
• Global adoption of VATS lobectomy has been slower than anticipated.
• Lack of consensus on VATS lobectomy training hinders widespread implementation.

Purpose of the Study:

• To present initial experience with a novel training model for VATS lobectomy.
• To address the divide between open and VATS lobectomy surgical techniques.
• To improve the integration of VATS lobectomy into surgical training programs.

Main Methods:

• A standardized three-port anterior approach was used for all VATS lobectomies.
• Two surgical registrars alternated roles as first surgeon and assistant under consultant supervision.
• Systematic lymph node dissection was performed in all cases.

Main Results:

• 22 VATS lobectomies were performed over 6 months, with 13 upper lobectomies.
• No emergency conversions to open surgery were required.
• No perioperative mortality was observed; common complications included atrial fibrillation and air leak.

Conclusions:

• VATS lobectomy is a team-based procedure, with significant roles for both surgeon and assistant.
• The proposed training model, utilizing two trainees and a supervisor, enhances intuitive learning and teaching.
• This accelerated training approach is expected to reduce the learning curve and improve safety in VATS lobectomy.