Content from the Journal of the American Neurological Surgeons.
Four experts on the surgical treatment of atrial fibrillation met at the 2017 STS Annual Meeting in Houston, Texas, to discuss the recently released STS clinical practice guidelines on the subject. James Edgerton of the Heart Hospital Baylor Plano is joined by Niv Ad and Vinay Badhwar of the West Virginia University Heart and Vascular…
Paul Van Schil of Antwerp University Hospital, Antwerp, Belgium, argues that surgery offers the best outcome for patients with mesothelioma. Dr. Van Schil reviews the evidence from surgical trials, noting a shift in practice towards extended pleurectomy-decortication. This is the counter argument to Robert Rintoul’s talk asserting that the role of surgery with respect to…
Pulmonary segmentectomy requires intraparenchymal dissection to expose the vessels and bronchi. This type of dissection is done bluntly during VATS, and can lead to air leak. Use of the robot enables meticulous dissection with less air leak, leading to better post-operative outcomes and decreased length of stay.
Originally presented as a STSA/CTSNet Surgical Motion Picture at the 2016 STSA Annual Meeting. Objectives: A 3.7 kg 27-day-old male baby was diagnosed with Tetralogy of Fallot with Ebstein’s anomaly. The initial presentations were respiratory distress and hypotension. Cyanosis was also noted after his PDA closure. The authors present the surgical technique to repair this…
Bone allograft transplantation represents a new option for anterior chest wall reconstruction. The disadvantages of synthetic materials are: excessive rigidity with risk of erosion of adjacent structures, the risk of infection, insufficient strength, immunological reaction, lack of incorporation into the host tissue, and sub-optimal radiological transparency. Moreover, the use of synthetic materials is not indicated…
“It is through multidisciplinary training and interaction that we all learn how to care for patients better,” Jill Ley, a clinical nurse specialist at California Pacific Medical Center, says in roundtable filmed at the 2017 STS Annual Meeting in Houston, Texas. Ms. Ley is joined by Prakash Patel of the University of Pennsylvania, Kathryn Gray…
Robert Rintoul of Papworth Hospital, Cambridge, UK, reviews the outcomes of major mesothelioma trials, and argues that all mesothelioma surgery is currently palliative. This is part one of a debate on how best to treat patients with mesothelioma. This presentation was originally given during the SCTS Ionescu University program at the 2016 Annual Meeting of…
This video shows the treatment of a 4-month-old male patient, who was diagnosed with a large ventricular septal defect after evaluation for respiratory distress. He demonstrated moderate congestive heart failure symptoms with medical management, and was referred for surgical closure. Echocardiogram revealed a very large supracristal VSD without distortion of the aortic valve or aortic…
A 62-year-old man with a history of arterial hypertension, diabetes mellitus, and prior smoking underwent a sigmoidectomy in 2011 for an adenocarcinoma, and received adjuvant chemotherapy. In 2013, after 24 months of follow-up, bilateral pulmonary nodules and mediastinal lymph nodes appeared. The first biopsy was negative. In 2014, a new fine-needle biopsy showed pulmonary metastases.…
Originally presented as an STSA/CTSNet Surgical Motion Picture at the 2016 STSA Annual Meeting. Objectives: Mitral valve reconstruction is now the primary surgical approach in mitral endocarditis, with better early and late outcomes than prosthetic valve replacement. However, certain pathologies can be difficult, and reports of extension to a robotic platform have been limited. This…
This video shows a thymectomy for a thymic cyst and a wedge resection of a nodule in the right upper lobe. A subxyphoid uniportal VATS approach was used.
Mattia Glauber of Instituto Clinico Sant Amgrogio, Milan, Italy, argues in favor of the right anterior mini-thoracotomy approach for minimally invasive aortic valve replacement. Dr. Glauber uses a short video to illustrate the technique of sutureless valve insertion. This presentation was originally given during the SCTS Ionescu University program at the 2015 Annual Meeting of…
This video shows a VATS resection of pulmonary sequestration in a previously healthy 55-year-old woman, who presented with chest pain. Pulmonary sequestration is a rare congenital abnormality of the lung consisting of nonfunctioning lung tissue that does not have normal communication with the tracheobronchial tree or pulmonary arteries. The lung receives its blood supply from…
Case Summary: A 48-year-old diabetic man presented with sudden onset paraplegia and pain in the lower extremities lasting four hours. Lower limb pulses were absent and CT angiogram revealed a saddle embolus at the aortoiliac bifurcation. Urgent bilateral retrograde femoral embolectomy was attempted, but failed. The patient underwent urgent laparotomy, aortotomy, and clot evacuation with…
This video shows a step-by-step approach to a robotic right middle lobectomy with a subxiphoid utility port. The authors have found that replacing the traditional assistant port with a 12 mm subxiphoid port reduces the clashing between instruments, offers a good angle for firing the stapler on hilar structures, and provides a direct view of…
In an interview filmed at Birmingham Children’s Hospital, United Kingdom, Priyadharshanan Ariyaratnam talks with William Brawn. Dr. Brawn is a leading authority on congenital heart surgery and has received a CBE from Queen Elizabeth II in recognition of his outstanding clinical work. He has performed over 3,000 operations and published over a 100 peer-reviewed publications…
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