- Email: [email protected]
Minimally Invasive Thoracic Surgery
Journal of Surgical Research 175, 220 (2012) doi:10.1016/j.jss.2011.05.054
COMMENTARY Minimally Invasive Thoracic Surgery Originally submitted April 30, 2011; accepted for publication May 25, 2011
Minimally invasive surgery is rapidly gaining popularity due to the smallsize incision and the potential for rapid postoperative recovery. Patients often demand this approach for even the most complex surgical diseases. In order to stay competitive in the field of thoracic surgery, one must embrace new innovations and technology for the ultimate goal of improving patient care. Dr. Liu and colleagues took minimally-invasive procedures to the limit and elegantly demonstrated the technical feasibility of using natural orifice transluminal endoscopic surgery (NOTES) for lung biopsy and pericardiotomy in an animal model [1]. There is no doubt that applying NOTES to thoracic cavity is an extremely technically-demanding task. The authors are to be congratulated for their perseverance in this study. Although NOTES have been more widely accepted in abdominal operations, its application in thoracic surgery has been limited. A bulk of the literature in minimally invasive thoracic surgery is limited to video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery. Unlike the rapid adoption of laparoscopic cholecystectomy, an overwhelming majority of lung cancer resections are still being performed via the traditional open thoracotomy instead of VATS [2]. With the advent of nano-technology, instrumentations for minimally invasive surgery including VATS and NOTES will become smaller and more precise. Even then, outcomes of minimally invasive procedures must be benchmarked against outcomes of traditional open procedures. In order for a particular minimally invasive procedure to be adopted fully, three criteria must be satisfied. First, it must have similar or better outcomes than the traditional open procedure. Second, it must better for patient. Third, it must be teachable to the ‘‘average’’ surgeon. Danny Chu, M.D., F.A.C.S.1 Baylor College of Medicine Michael E. DeBakey VA Medical Center Houston, Texas
REFERENCES 1. Ko PJ, Chu Y, Wu YC, et al. Feasibility of endoscopic transoral thoracic surgical lung biopsy and pericardial window creation. J Surg Res 2012;175:207. 2. Gopaldas RR, Bakaeen FG, Dao TK, et al. Video-assisted thoracoscopic versus open thoracotomy lobectomy in a cohort of 13,619 patients. Ann Thorac Surg 2010;89:1563. 1
To whom correspondence and reprint requests should be addressed at Baylor College of Medicine, Michael E. DeBakey VA Medical Center, Cardiothoracic Surgery, OCL 112, 2002 Holcombe Blvd, Houston, TX 77030. E-mail: [email protected].
0022-4804/$36.00 Published by Elsevier Inc.
220
COMMENTARY Minimally Invasive Thoracic Surgery Originally submitted April 30, 2011; accepted for publication May 25, 2011
Minimally invasive surgery is rapidly gaining popularity due to the smallsize incision and the potential for rapid postoperative recovery. Patients often demand this approach for even the most complex surgical diseases. In order to stay competitive in the field of thoracic surgery, one must embrace new innovations and technology for the ultimate goal of improving patient care. Dr. Liu and colleagues took minimally-invasive procedures to the limit and elegantly demonstrated the technical feasibility of using natural orifice transluminal endoscopic surgery (NOTES) for lung biopsy and pericardiotomy in an animal model [1]. There is no doubt that applying NOTES to thoracic cavity is an extremely technically-demanding task. The authors are to be congratulated for their perseverance in this study. Although NOTES have been more widely accepted in abdominal operations, its application in thoracic surgery has been limited. A bulk of the literature in minimally invasive thoracic surgery is limited to video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery. Unlike the rapid adoption of laparoscopic cholecystectomy, an overwhelming majority of lung cancer resections are still being performed via the traditional open thoracotomy instead of VATS [2]. With the advent of nano-technology, instrumentations for minimally invasive surgery including VATS and NOTES will become smaller and more precise. Even then, outcomes of minimally invasive procedures must be benchmarked against outcomes of traditional open procedures. In order for a particular minimally invasive procedure to be adopted fully, three criteria must be satisfied. First, it must have similar or better outcomes than the traditional open procedure. Second, it must better for patient. Third, it must be teachable to the ‘‘average’’ surgeon. Danny Chu, M.D., F.A.C.S.1 Baylor College of Medicine Michael E. DeBakey VA Medical Center Houston, Texas
REFERENCES 1. Ko PJ, Chu Y, Wu YC, et al. Feasibility of endoscopic transoral thoracic surgical lung biopsy and pericardial window creation. J Surg Res 2012;175:207. 2. Gopaldas RR, Bakaeen FG, Dao TK, et al. Video-assisted thoracoscopic versus open thoracotomy lobectomy in a cohort of 13,619 patients. Ann Thorac Surg 2010;89:1563. 1
To whom correspondence and reprint requests should be addressed at Baylor College of Medicine, Michael E. DeBakey VA Medical Center, Cardiothoracic Surgery, OCL 112, 2002 Holcombe Blvd, Houston, TX 77030. E-mail: [email protected].
0022-4804/$36.00 Published by Elsevier Inc.
220