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Thoracoscopic surgery: the Belgian experience

W Coosemans1, T E Lerut, D E Van Raemdonck

  • 1Division of Thoracic Surgery, U.Z. Gasthuisberg, Leuven, Belgium.

The Annals of Thoracic Surgery
|September 1, 1993
PubMed
Summary
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Video-assisted thoracic surgery is emerging, with most surgeons having limited experience. While successful for many procedures like pneumothorax, careful patient selection and expertise are crucial for optimal outcomes.

Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Surgical Innovation

Background:

  • Video-assisted thoracic surgery (VATS) is a developing field, lagging behind general laparoscopic surgery.
  • A survey of Belgian surgeons revealed limited experience, with a majority performing 1-5 interventions.

Purpose of the Study:

  • To assess the current state and outcomes of video-assisted thoracic surgery based on a survey of Belgian surgeons and the authors' own experience.
  • To evaluate the technical success rates and identify factors influencing outcomes in various VATS procedures.

Main Methods:

  • A survey collected data on 296 VATS interventions performed by Belgian surgeons.
  • The authors reviewed their own experience with 71 VATS interventions.
  • Data analyzed included procedure types, technical success rates, and complications.

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Main Results:

  • The majority of VATS procedures involved pneumothorax treatment, lung biopsies, wedge resections, and staging (70%).
  • Overall technical success rates were 91% in the survey and 85% in the authors' experience.
  • Recurrences for pneumothorax decreased significantly after the introduction of endostaplers.

Conclusions:

  • Video-assisted thoracic surgery offers new possibilities but requires careful patient selection and surgical expertise comparable to open procedures.
  • While successful, VATS procedures can be time-consuming and may require one-lung ventilation, posing potential risks.
  • The development of techniques like video-assisted mediastinoscopy enhances teaching and procedural interpretation.