Video-assisted thoracoscopic surgery using a three-dimensional thoracoscopic system as an educational tool for surgical
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ORIGINAL ARTICLE
Video‑assisted thoracoscopic surgery using a three‑dimensional thoracoscopic system as an educational tool for surgical trainees in general thoracic surgery Takeshi Mimura1 · Atsushi Kagimoto1 · Tatsuya Miyamoto1 · Chika Nakashima1 · Mai Nishina1 · Yuya Hirai1 · Atsushi Kamigaichi1 · Yoshinori Yamashita1 Received: 17 July 2020 / Accepted: 29 September 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Objective The clinical practice of safe and efficient surgery and professional development of general thoracic surgical trainee are both important issues for mentors. We investigated the usefulness of a three-dimensional (3D) endoscopic system application for lung cancer treatment as a tool for training surgical trainees. Methods Supervised by mentors, general thoracic surgical trainees were trained with video-assisted thoracoscopic surgery (VATS) for primary lung cancer using a 3D endoscopic system to enable them to become operators. Video clinics using 3D images were held weekly. The group using 3D endoscopic system (66 cases in the 3D-VATS group) was compared with the group using conventional two-dimensional (2D) thoracoscopic system (35 cases in the 2D-VATS group) to perform VATS lobectomies. Results There was no significant difference in operative time between both groups. However, the 3D-VATS group comprised significantly less experience than the 2D-VATS group. The intraoperative blood loss was significantly reduced for the 3D group (34 mL in the 3D-VATS group vs. 76 mL in the 2D-VATS group, P = 0.0007). There were no cases of conversion from VATS to open thoracotomy and intraoperative transfusion in either group. Conclusion 3D-VATS and video clinics using 3D videos are useful training tools for general thoracic surgical trainees with little experience in open thoracotomy. Keywords Lung cancer · Lobectomy · Three-dimensional endoscopic system · Education
Introduction In the era of endoscopic surgery, when open thoracotomy has been drastically reduced [1], it is always a challenge for a surgical mentor to balance clinical practice and education efficiently while ensuring safety. One of the greatest advantages of endoscopic surgery is that the surgeon is able to share their view. However, due to the difficulty in grasping spatial perception in conventional two-dimensional (2D) monitored surgery, surgical trainees may take longer to learn surgical techniques. Although technological innovations in * Takeshi Mimura [email protected] 1
Department of General Thoracic Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, 3‑1, Aoyama‑cho, Kure, Hiroshima 737‑0023, Japan
imaging and surgical instruments, including robot-assisted surgery, have led to remarkable advances, it is important to consider the fact that surgical trainees must start their training from scratch, and accordingly, train them effectively. Earlier, we reported the usefulness of video-assisted thoracoscopic surgery (VATS) using a three-dimensional (3D) endoscopic system
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