Safety and Performance of Clinical Engineers as Thoracoscopic Scope Operators.

Area of Science:

• Thoracic Surgery
• Surgical Innovation
• Medical Technology

Background:

• Efforts in Japan aim to reduce physician workload in thoracoscopic lung resections.
• Clinical Engineers (CE) are being trained as scope operators (SO) to assist in these procedures.

Purpose of the Study:

• To evaluate the safety and learning curve of clinical engineer scope operator (CESO) assistants in VATS lobectomy.
• To assess the impact of CESO assistance on surgical outcomes and postoperative complications.

Main Methods:

• Analysis of surgical data and postoperative complications for VATS lobectomy cases from 2020-2023.
• Assessment of scope clearance sustainability (SCS) and comparison between CESO-assisted and non-CESO groups.
• Multivariate analysis to identify factors associated with postoperative complications.

Main Results:

• CESO-assisted procedures increased from 37% to 53% between 2020 and 2023.
• No significant differences in operating time, blood loss, or hospital stay were found between groups.
• Pulmonary air leakage >7 days was linked to complications; incomplete interlobar fissure was the only independent factor, unrelated to CESO involvement.
• Surgical technique stability was achieved within 18-28 cases, demonstrating a learning curve improvement.

Conclusions:

• Video-assisted thoracic surgery (VATS) with CESO assistance is a safe and reliable approach.
• CESO assistance demonstrates a favorable learning curve, with stability achieved within 20-30 cases.