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Updated: Dec 6, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Video-assisted thoracoscopic surgery using a three-dimensional thoracoscopic system as an educational tool for
Takeshi Mimura1, Atsushi Kagimoto2, Tatsuya Miyamoto2
1Department of General Thoracic Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure, Hiroshima, 737-0023, Japan. t.mimura88@gmail.com.
Objective:
The clinical practice of safe and efficient surgery and professional development of general thoracic surgical trainee are both important issues for mentors. We investigated the usefulness of a three-dimensional (3D) endoscopic system application for lung cancer treatment as a tool for training surgical trainees.
Methods:
Supervised by mentors, general thoracic surgical trainees were trained with video-assisted thoracoscopic surgery (VATS) for primary lung cancer using a 3D endoscopic system to enable them to become operators. Video clinics using 3D images were held weekly. The group using 3D endoscopic system (66 cases in the 3D-VATS group) was compared with the group using conventional two-dimensional (2D) thoracoscopic system (35 cases in the 2D-VATS group) to perform VATS lobectomies.
Results:
There was no significant difference in operative time between both groups. However, the 3D-VATS group comprised significantly less experience than the 2D-VATS group. The intraoperative blood loss was significantly reduced for the 3D group (34 mL in the 3D-VATS group vs. 76 mL in the 2D-VATS group, P = 0.0007). There were no cases of conversion from VATS to open thoracotomy and intraoperative transfusion in either group.
Conclusion:
3D-VATS and video clinics using 3D videos are useful training tools for general thoracic surgical trainees with little experience in open thoracotomy.
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