Image-guided Video-assisted Thoracoscopic Resection (iVATS): Translation to Clinical Practice-real-world Experience

Overview

Journal J Surg Oncol

Specialties General Surgery
Oncology

Date 2020 Mar 14

PMID 32166751

Citations 11

Authors

Ritu R Gill

Julianne Barlow

Michael T Jaklitsch

Eric J Schmidlin

Phillip M Hartigan

Raphael Bueno

Affiliations

Soon will be listed here.

Abstract

Objective: We developed a novel approach for localization and resection of lung nodules, using image-guided video-assisted thoracoscopic surgery (iVATS). We report our experience of translating iVATS into clinical care.

Methods: Methodology and workflow for iVATS developed as part of the Phase I/II trial were used to train surgeons, radiologists, anesthesiologists, and radiology technologists. Radiation dose, time from induction to incision, placement of T-bar to incision and incision to closure, hospital stay, and complication rates were recorded.

Results: Fifty patients underwent iVATS for resection of 54 nodules in a clinical hybrid operating room (OR) by six surgeons. Fifty-two (97%) nodules were successfully resected. Forty-two (84%) patients underwent wedge resection, four (7%) lobectomies, and two (4%) segmentectomy all with lymph node dissection. Median time from induction to incision was 89 minutes (range: 13-256 minutes); T-bar placement was 14 minutes (10-29 minutes); and incision to closure, 107 minutes (41-302 minutes). Average and total procedure radiation dose were: median = 6 mSieverts (range: 2.9-35 mSieverts). No deaths were reported and median length of stay was 3 days (range: 1-12 days).

Conclusions: Translation of iVATS into clinical practice has been initiated using a safe step-wise process, combining intraoperative C-arm computed tomography scanning and thoracoscopic surgery in a hybrid OR.

Citing Articles

Single-Stage Image-Guided Percutaneous Ablation with Thoracoscopic Resection for Multiple Pulmonary Lesions in a Hybrid Operating Room: A Retrospective Study.

Chang L, Su P, Chan P, Malwade S, Chung W, Yang S Cancers (Basel). 2024; 16(20).

PMID: 39456606 PMC: 11505936. DOI: 10.3390/cancers16203512.

Nontraumatic intraoperative pulmonary nodule localization with laser guide stamping in a hybrid operating room.

Yang S, Malwade S, Chung W, Chen L, Chang L, Chang H Updates Surg. 2024; 76(7):2531-2540.

PMID: 38872023 DOI: 10.1007/s13304-024-01911-6.

Presurgical computed tomography-guided localization of lung ground glass nodules: comparing hook-wire and indocyanine green.

Han R, Wang L, Teng F, Lin J, Xian Y, Lu Y World J Surg Oncol. 2024; 22(1):51.

PMID: 38336734 PMC: 10858508. DOI: 10.1186/s12957-024-03331-7.

Image-guided video-assisted thoracoscopic surgery (iVATS): a single center experience and review.

Pezeshkian F, McAllister M, Singh A, Jaklitsch M, Gill R, Bueno R J Thorac Dis. 2024; 15(12):7035-7041.

PMID: 38249864 PMC: 10797359. DOI: 10.21037/jtd-23-1461.

Role of subxiphoid uniportal video-assisted thoracoscopic surgery in pulmonary metastasectomy.

Elkhayat H, Hamza H, Elshoieby M, Omar M, Gaber E Kardiochir Torakochirurgia Pol. 2023; 19(4):232-239.

PMID: 36643341 PMC: 9809182. DOI: 10.5114/kitp.2022.122094.

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