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At least 91 records · Page 5Linked to original sources
PubMed2004

Thoracoscopic placement of dual-rod instrumentation in thoracic spinal trauma.

OBJECTIVE AND IMPORTANCE: Traditionally, thoracic fractures that require anterior stabilization are treated through an open thoracotomy approach. Thoracoscopic instrumentation avoids many of the complications associated with an open thoracotomy but is technically challenging. We report the first cases of dual-rod internal fixation systems placed thoracoscopically for thoracic spinal trauma. CLINICAL PRESENTATION: Two male patients sustained midthoracic spinal trauma falling from motorcycles in separate incidents. Both injuries led to unstable spinal columns, but the patients had no neurological deficits and had minimal spinal cord compression. One patient had a complex spiral fracture from T6 to T8; the other had T7 burst and T8 compression fractures. Based on the complex morphological features of the patients' fractures, anterior internal fixation was the treatment of choice for both. The two available options for an anterior stabilization were open thoracotomy and thoracoscopic instrumentation. Because extensive decompression was unnecessary, a thoracoscopic approach was used. INTERVENTION: A dual-rod internal fixation system (Medtronic Sofamor Danek, Inc., Memphis, TN) was placed with two screws each in the T6 and T9 vertebral bodies of each patient. Thoracoscopy was used for direct visualization of the operative site with fluoroscopic guidance for screw placement. Surgery was completed without complications, and both patients did well afterward. Upright and supine x-rays demonstrated that the constructs were stable at 10 weeks and 6 months, respectively. CONCLUSION: Thoracoscopic instrumentation offers the advantages of a minimally invasive approach but is technically challenging. The characteristics of dual-rod fixation systems (small-profile components and step-wise insertion) provide the best biomechanical profile and facilitate thoracoscopic instrumentation.

Adult↗
PubMed1998

Thoracoscopic splanchnicolysis for the relief of chronic pancreatitis pain: experience of a group of pneumologists.

Intractable pain is the most invalidating symptom in patients suffering from chronic pancreatitis. Anatomical interruption of the major afferent pain nerves is indicated in severe refractory cases. Among the various techniques and sites of interruption, thoracoscopic splanchnicectomy has emerged as an efficient alternative for the more aggressive open surgical splanchnicectomy, and for the (solely temporarily efficacious) transcutaneous neural blocks, which moreover bear some serious complications. Until now, all reports on thoracoscopic splanchnicectomy were typically surgical, using video-assisted thoracoscopic surgery techniques, double-lumen intubation, and so on. In analogy with thoracoscopic upper dorsal T2-T3 sympathicolysis for essential hyperhidrosis, a simplified thoracoscopic splanchnicolysis technique used in 8 patients suffering from either severe refractory chronic pancreatitis pain (7 patients) or postsurgical epigastric pain is described. Pain control was achieved in 5 of the 7 patients with chronic pancreatitis with a short (20+/-8 min) intervention, short hospitalization (2 days), and simple (single-lumen intubation, no chest drains) procedure. Thus, this simplified thoracoscopic splanchnicolysis technique may represent a valid alternative in the often difficult treatment of refractory chronic pancreatitis pain or other upper abdominal pain.

Abdominal Pain↗
PubMed2004

A new safe and stable spiral wire needle for thoracoscopic resection of lung nodules.

BACKGROUND: To show the safety and stability of a spiral wire needle (Somatex; Rietzneuendorf, Germany) in the detection and subsequent thoracoscopic resection of subpleural and/or small nodules of the lung. METHODS: Under local anesthesia and CT control, 13 patients underwent the positioning of a spiral wire needle into the lung, with the spiral located close to or inside the nodule to be resected. Then the patients underwent video-assisted thoracoscopic surgery resection of the nodules with only two thoracoscopic accesses. RESULTS: All the nodules were identified due to the precise location of the spiral wire needle. The presence of a stable spiral wire inside the parenchyma has allowed us to put under tension the overlying parenchyma, which had previously been excluded from ventilation. The external traction on the needle facilitates the detection of the nodule and simplifies thoracoscopic resection with a stapler. With this new tool, we have always reached an adequate diagnosis and observed no cases of dislodgment of the needle during the traction maneuvers, nor cases of conversion from thoracoscopy to thoracotomy. CONCLUSIONS: Although our initial experience is limited, the use of this spiral wire needle has been shown to be extremely advantageous in identifying subpleural and/or small nodules of the lung, even sparing the classic third thoracoscopic access for their resection. The presence of a wire needle with a spiral terminal portion (which is placed firmly inside the lung parenchyma) is very useful for the thoracoscopic resection of pulmonary nodules.

Adult↗
PubMed2006

Therapy of parapneumonic effusions in children: video-assisted thoracoscopic surgery versus conventional thoracostomy drainage.

OBJECTIVE: Controversy surrounds the optimal treatment of parapneumonic effusions. This trial of pediatric patients with community-acquired pneumonia and associated parapneumonic processes compared primary video-assisted thoracoscopic surgery with conventional thoracostomy drainage. DESIGN: A prospective, randomized trial was conducted at DeVos Children's Hospital (Grand Rapids, MI) between November 2003 and May 2005. All of the patients under 18 years of age with large parapneumonic effusions were approached for enrollment in the study. After enrollment, each patient was randomly assigned to receive either video-assisted thoracoscopic surgery or thoracostomy tube drainage of the effusion. Subsequent therapies (fibrinolysis, imaging, and further drainage procedures) were similar for each group per protocol. RESULTS: Eighteen patients were enrolled in the study: 10 in video-assisted thoracoscopic surgery and 8 in conventional thoracostomy. The groups were demographically similar. No mortalities were encountered in either group, and everyone was discharged from the hospital with acceptable outcomes. Yet, there were multiple variables that demonstrated statistical difference. Hospital length of stay, number of chest tube days, narcotic use, number of radiographic procedures, and interventional procedures were all less in the patients who underwent primary video-assisted thoracoscopic surgery. In addition, no patient in the video-assisted thoracoscopic surgery group required fibrinolytic therapy, which was also statistically different from the thoracostomy drainage group. CONCLUSIONS: The outcomes of this study strongly suggest that primary video-assisted thoracoscopic surgery for evacuation of parapneumonic effusions is superior to conventional thoracostomy drainage.

Child↗
PubMed2000

Thoracoscopic resection as the preferred approach to posterior mediastinal neurogenic tumors.

Traditionally, resection of posterior mediastinal neurogenic tumors (PMNTs) has been through a posterolateral thoracotomy. Although thoracoscopic resection of these tumors has been advocated, treatment guidelines have not been reported previously. The authors report a thoracoscopic resection of a PMNT and conducted a retrospective review of similar cases in the literature. Successful thoracoscopic resection was compared with tumor size and type using a nonpaired t test (alpha: P < 0.05). A total of 29 patients (13 men, 16 women), aged 26 to 68 years, who underwent a thoracoscopic resection of a PMNT were identified. Preoperative imaging included chest radiography and computed tomography in all patients and magnetic resonance imaging in 15 of 29 patients (52%). All tumors were located in the posterior mediastinum without preoperative evidence of invasion or malignancy. Conversion to an open procedure was necessitated in 12 of 29 (41%) patients ("minithoracotomy" in 11, posterolateral thoracotomy in 1). Tumor size necessitating conversion to an open procedure (mean = 4.79 cm) and tumor size amenable to thoracoscopy alone (mean = 3.84 cm) were not significantly different (P < 0.09). Pathology revealed 22 schwannomas (76%), 6 ganglioneuromas (21%), and 1 malignant schwannoma (3%) and was not associated with conversion to an open procedure (P < 0.99). Thoracoscopic resection of PMNTs can be performed successfully, regardless of tumor type or size; however, malignancy, local invasion, and tumors >5 cm may require an open procedure. Thoracoscopic resection can replace thoracotomy in the treatment of PMNTs.

Humans↗
PubMed2002

[Video-assisted thoracoscopic lobectomy--preliminary experience].

BACKGROUND: Video-assisted thoracoscopic surgery has become routine worldwide. On the basis of accumulating experience and technologic improvements, more complex operations can be performed. Until recently, thoracoscopic lobectomy has not been performed in Israel. GOALS: To describe the initial experience with thoracoscopic lobectomy in Sheba Medical Center, and discuss the advantages, disadvantages and indications for its use. MATERIAL & METHODS: From June 2000 to January 2001, five patients (3 male, 2 female) 22-72 year-old underwent thoracoscopic lobectomy. Four had malignant neoplasms (3 lung primary) and one a benign process. Preparations for surgery, anesthesia and monitoring were standard as for open lobectomy. Surgery was done through 3 ports and a 5-7 cm auxiliary thoracotomy. The majority of the operation was performed with staplers. In patients with lung tumors the regional lymph nodes were sampled. Pulmonary function tests were evaluated prior to surgery and in the immediate postoperative period. RESULTS: Lobectomy was completed in all patients according to preoperative planning without conversion to open thoracotomy. Operative time was 120-160 minutes. Blood transfusion was not required in any patient during or after the lobectomy. There was no operative mortality and only two minor complications in one patient. Narcotic requirement did not exceed 40 mg of morphine in any patient. Pulmonary function tests revealed a smaller than expected decrease compared to open thoracotomy. The cosmetic results were excellent. CONCLUSIONS: Thoracoscopic lobectomy is feasible in Israel too. It is an acceptable alternative for patients needing this operation. Thoracoscopic lobectomy causes less surgical trauma, better functional result and expectance for lowered mortality and morbidity. Its main disadvantage is its high cost.

Adult↗
PubMed2002

[Thoracoscopic esophagectomy].

The current roles of thoracoscopic esophagectomy in the treatment of cancer in Japan are described. Lymphadenectomy of the same quality as open surgery should be performed thoracoscopically to obtain good oncological outcomes. The indications for thoracoscopic esophagectomy are 1) no extensive pleural adhesions; 2) pulmonary function sufficient for single-lung ventilation; and 3) tumor not invading other organs. Hand-assisted or mini-thoracotomy facilitates the dissection of lymph nodes, especially on the left side of the trachea. However, for any type of procedure, a good en-face view is essential for safe and accurate lymphadenectomy. The magnifying effect of video, with the camera in close proximity, is important to maintain a proper dissecting plane. Although sufficient experience is necessary to master the learning curve, lymphadenectomy of the same quality as open surgery can be performed with mini-thoracotomy in a feasible time period. Thoracoscopic esophagectomy contributes to reducing postoperative pain and constrictive pulmonary dysfunction. It may be too soon to assert that the thoracoscopic approach can provide oncological outcomes comparable to those after open surgery because long-term follow up is not yet sufficient. Thoracoscopic esophagectomy, however, has the potential to improve the postoperative quality of life of patients with esophageal cancer.

Esophageal Neoplasms↗
PubMed2003

Thoracoscopic multilevel anterior instrumented fusion in a goat model.

STUDY DESIGN: A survival study in a caprine model for evaluation of a thoracoscopic anterior scoliosis instrumentation construct for fusion. OBJECTIVE: To compare the efficacy of performing multilevel anterior thoracoscopic "scoliosis" fusion with both allograft and autograft bone. SUMMARY OF BACKGROUND DATA: The use of minimally invasive thoracoscopic spinal surgery has been increasing. Until recently, instrumentation methods for correcting scoliosis entirely with a minimally invasive approach have not been available. Although multilevel thoracoscopic instrumentation and fusion now is in use clinically at some centers, reports of its effectiveness in an animal model are limited. METHODS: A thoracoscopically implanted multilevel screw-rod instrumentation construct was used in a goat survival model, with fusion quality evaluated 16 weeks after surgery. Autogenous iliac crest bone graft was compared with an allogenic bone graft substitute. The quality of fusion was evaluated both radiographically and biomechanically. RESULTS: Thoracoscopic insertion of a multilevel screw-rod construct was demonstrated to be technically feasible. However, with regard to the quality of fusion, only 47% of the disc space "fusion ratings" with the use of autogenous iliac crest graft were considered fully fused by computed tomography scan evaluation. This compares with no ratings of full fusion in the allograft demineralized bone group and only a single rating of full disc space fusion in the control group, which received no bone graft. Torsional range of motion was the smallest in the group receiving iliac crest bone graft and the greatest in the control animals that did not undergo bone grafting. CONCLUSIONS: The lack of complete fusion at 4 months in the autogenous iliac crest group emphasizes the importance of the discectomy and bone grafting technique. The use of demineralized bone allograft as a sole source of interbody fusion is not supported.

Animals↗
PubMed2004

[Thoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis: a comparison of their clinical results].

OBJECTIVE: To compare the early clinical results of thoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis. METHODS: Twenty-three cases with idiopathic right thoracic scoliosis were divided into 2 groups. Group A includes 8 females with average age of 14.8 years and average Cobb angle of 54 degrees . The Risser sign was +++ approximately ++++. These patients were operated on with thoracoscopic Eclipse instrumentation. Group B covers 2 males and 13 females with average age of 13.8 years and average Cobb angle of 57 degrees . The Risser sign was ++ approximately ++++. These patients were operated on with mini-open thoracotomic anterior instrumentation. The operative time, blood loss, postoperative drainage, instrumented levels, curve correction and early loss of correction of both groups were analyzed. RESULTS: The patients of group A had average operative time of (360 +/- 72) min, (629 +/- 145) ml of intra-operative blood loss, (7.4 +/- 1.1) of instrumented levels, (500 +/- 150) ml of post operative drainage, 74 +/- 14% of curve correction rate and (8.6 +/- 2.7)% of early loss of correction after 6 approximately 18 m follow-up. The patients of group B had average operative time of (246 +/- 64) min, (300 +/- 110) ml of intra-operative blood loss, (7.8 +/- 0.9) of instrumented levels, (210 +/- 90) ml of post operative drainage, (70 +/- 12)% of curve correction rate and (4.6 +/- 1.9)% of early loss of correction. The curve correction rates of thoracoscopic and mini-open thoracoscopic anterior correction were not significantly different (P >0.05). But the operative time, blood loss, postoperative drainage, and early loss of correction showed significant difference (P <0.05). CONCLUSIONS: Thoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis have their own indications. Both techniques are safe and effective to correct the idiopathic thoracic scoliosis with satisfied early results. But the early loss of correction of mini-open thoracotomic anterior correction is significantly less than that of thoracoscopic anterior correction.

Adolescent↗
PubMed1980

[Thoracoscopic lung biopsy (author's transl)].

The authors start from the fact that till now was a declining attitude in face of the thoracoscopic lung biopsy. Under local anaesthesia any air embolism were happened with it. Moreover there was no optimal instrument for thoracoscopic lung biopsy. Beginning with pressure measurements of the intrathoracic cavity systems the authors research the conditions which can result in air embolism. They found that air embolism is excluded only by unilateral ventilation of the non-biopsied lung of the patient via a channel of Carlens' double-lumen catheter. The other channel of the cathetaer which is connected with the thoracoscopically biopsied lung must be aggreed with the atmosphere in the same way as the pleural space via the open thoracoscope tube. Further it was developed the suction punch, a special instrument for thoracoscopic lung biopsy. In this instrument the proceedings of catch and detache the tissue from the parenchyma are divided contrarily to the forcepslike devices. With this new instrument 63 patients were examined. The thoracoscopic lung biopsy was performed under general anaesthesia with side-separated ventilation through Carlens' catheter. The histologically verified diagnostic yielded was 89 per cent. There aren't serious complications.

Biopsy↗
PubMed1994

[Thoracoscopic treatment of intrathoracic diseases].

Recently developed thoracoscopic surgical equipment and related instruments have enabled us to perform two groups of advanced thoracoscopic surgical procedures. Group 1: procedures formerly performed by open thoracotomy, and group 2: procedures performed by thoracoscopic surgery only. Group 1 includes bullectomy for spontaneous pneumothorax, wedge resection for lung nodules, resection of benign tumors of the mediastium or chest wall, lung lobectomy, and resection of giant bullae. Because thoracoscopic surgery is minimally invasive, intrathoracic surgical procedures should be performed by thoracoscopic surgery if the results are the same. Group 2 consists of surgery in patients with poor pulmonary reserve and laser ablation of the bullous lung in advanced emphysema. Until recently, surgical intervention was not an option in the patients in groups 2 because of the invasiveness of open thoracotomy. Thoracoscopic surgery allows resection of tumors in early stage lung cancer in patients with poor pulmonary reserve. Severely emphysematous lungs can be ablated with a laser and shrunk, to normalize pulmonary compliance, residual volume and total lung capacity, and thus relieve symptoms.

Humans↗
PubMed1995

[A case of diffuse malignant mesothelioma diagnosed by thoracoscopic biopsy].

We report a case of diffuse malignant mesothelioma discovered by thoracoscopic examination undertaken while formulating a preoperative diagnosis. A 61-year-old male complained of coughing and sputum production, and was admitted because his chest roentgenogram indicated an abnormal shadow. Chest CT scanning demonstrated right pleural effusion and multiple nodules sited on the diaphragm. Because aspiration biopsy of such nodules was difficult, we performed a thoracoscopic examination. The thoracoscopic findings demonstrated bloody pleural effusion in the right thoracic cavity and multiple nodules on the diaphragm, parietal and pulmonary pleura. They were white and 0.5 to 2 cm in size. By excisional biopsy, these were diagnosed as epithelial-type diffuse malignant mesothelioma. We therefore performed panpleuropneumonectomy. Even though we completely resected the canal of thoracoscope and drainage tube, microscopic findings showed invasion of mesothelioma cells into this thoracoscopic canal. Although we suggest that, in preoperative diagnosis of pleural tumor, thoracoscopy is efficient to perform a pathological examination and confirm the extension of tumor, in the actual operation, we believe that the thoracoscopic canal should be resected.

Biopsy↗
PubMed1995

[Can a reduction of morbidity of esophagectomy be expected with the thoracoscopic approach?].

OBJECTIVE: Oesophagectomies have a high morbidity rate, mainly related to pulmonary complications. The aim of this work was to assess whether the thoracoscopic approach could reduce this morbidity. PATIENTS AND METHODS: We conducted a prospective study of the results of 26 attempts of esophagectomy using a right thoracoscopic approach. There were 17 males and 9 females having an average age of 47. The indication was a squamous cell carcinoma in 19 patients, an adenocarcinoma in 1 patient, a melanoma in 1 patient and a caustic stenosis in 5. The whole oesophagus was mobilized thoracoscopically, and the eosophagectomy was completed through the abdomen. The reconstruction was achieved using a gastric pull-through and a cervical anastomosis. RESULTS: There were 5 failures for the following reasons: unresectable carcinoma (1 case), large tumour making a thoracoscopic dissection unsafe (1 case) and incomplete lung collapse making the exposure of the posterior mediastinum difficult (2 cases). The average time of the thoracoscopic procedure was 135 min. The post-operative course was uneventful in all but 5 patients who had a pulmonary complication: atelectasis (3 cases), right purulent pleural effusion (1 case), acute respiratory distress syndrome (1 case). The latter complication was lethal. Four out of 5 respiratory complications occurred in patients for whom the dissection was considered as difficult. Among the other complications, there were 5 anastomotic leakages and 3 laryngeal nerve palsy. The mortality rate was 3.8%. CONCLUSION: These initial results do not show a real benefit of the thoracoscopic approach for eosophageal dissection, especially for difficult oesophagectomies. Further evaluation of the technique is needed.

Burns, Chemical↗
PubMed1995

[Thoracoscopic surgery].

Thoracoscopic operations were performed on 91 patients. In 52 patients operated on by thoracoscopic pleurodesis for pneumothorax, the results were compared with the results in 41 patients previously operated on by transaxillary thoracotomy. The groups did not differ with respect to duration of stay in hospital or minor complications, but the duration of postoperative sick leave was significantly reduced after thoracoscopic operation. In nine cases lung metastasis or primary lung tumours were removed thoracoscopically. Thoracoscopic evacuation were performed in seven cases of empyema or pleural haematoma. Two of these patients were later operated on by open decortication. The main advantages of thoracoscopic surgery are less postoperative pain and a shorter time away from work after operation than with open procedures.

Adolescent↗
PubMed1994

[Thoracoscopic resection of mediastinal tumors].

Thoracoscopic surgery was performed in nine patients with benign mediastinal tumors: four neurogenic tumors, three bronchogenic cysts, a foregut cyst and a mature teratoma. Four cystic masses located in para-esophageal lesion in inferior mediastinum and four neurogenic tumors located in posterior mediastinum. A mature teratoma was adjacent to thymus in anterior mediastinum. Under general anesthesia with unilateral ventilation, the patients were turned in the lateral decubitus position and we tilt the operative table to allow gravity assistance for the displacement of the lung. A rigid telescope was inserted through a thracoport. Masses were resected using the dissecting scissors with electric cautery through two other thracoports. Thoracoscopic complete resections were performed in eight patients. In one case that was suspected of malignant tumor by preoperative evaluation, thoracoscopic tumor biopsy was performed and diagnosed as a benign neurogenic tumor during operation histopathologically. But it was resected by thoracotomy, because of its larger size (8 cm in diameter). The average operation time was 122 minutes ranging from 80 to 184 minutes in 8 patients with thoracoscopic resection. No patient has a complication resulting from the thoracoscopic surgery. The chest drainage tubes were removed on 1 or 2-POD in all cases and the average length of postoperative hospitalization was 5.3 days ranging from 4 to 9 days. The thoracoscopic resection for benign mediastinal tumors is minimally invasive and effective procedure compared with classical thoracotomy operation.

Adolescent↗
PubMed1993

Thoracoscopic stapled resection for spontaneous pneumothorax.

Video-assisted thoracoscopy has recently evolved as an alternative to thoracotomy for several thoracic disorders. Spontaneous pneumothorax may be ideally suited for thoracoscopic management. Stapling of apical blebs and pleurodesis or pleurectomy can now be performed thoracoscopically in a fashion identical to the standard operation done through a lateral or axillary thoracotomy. We compared our results with thoracoscopic management of spontaneous pneumothorax in 26 patients (group I) with a group of 20 patients previously subjected to axillary thoracotomy (group II). Indications for operation, sex distribution, and average age (group I, 32.3 years; group II, 33.7 years) were comparable. Hospital stay was less in group I (2.88 +/- 0.99 days versus 4.47 +/- 1.07 days; p = 0.07), as was the use of parenteral narcotics after 48 hours (2/26 = 7.7% versus 14/20 = 70%; p = 0.01). There have been no recurrences to date (mean follow-up, 8 months) in the thoracoscopic group. Video-assisted thoracoscopic management of spontaneous pneumothorax allows performance of the standard surgical procedure while avoiding the thoracotomy incision. Video-assisted thoracoscopic management is safe and offers the potential benefits of shorter hospital stays and less pain.

Adult↗
PubMed1998

[Thoracoscopic surgery using voice controlled robot for spontaneous pneumothorax].

We investigated the feasibility and applicability of using voice controlled robot-assisted thoracoscopic surgery for spontaneous pneumothorax. Eleven patients with spontaneous pneumothorax were involved in this study. Five patients were treated by voice controlled robot-assisted thoracoscopic procedure and 6 by historical human-assisted thoracoscopic procedure. All procedures were successfully completed without complications. The number of times the thoracoscope required cleaning per 60-minute interval for cases involving voice controlled robot-assisted surgery were 1.4 compared to 8 per 60-minute interval for comparable cases when the robot was not used. Operative times, the amount of analgesics, the duration of indwelling chest tube, the number of recurrences after operation during thoracoscopic procedures were not statistically different. We found that use of voice-controlled robot as surgical assistant during thoracoscopic surgery for spontaneous pneumothorax is feasible.

Adolescent↗
PubMed1999

Thoracoscopic procedures for intrathoracic and pulmonary diseases.

Since Jacobaeus performed the first thoracoscopy to explore pleural space and mechanically broke pleural adhesions to facilitate the collapse therapy for pulmonary tuberculosis in 1910, numerous thoracic surgeons have been attempting this technique as a means of accomplishing many intrathoracic procedures previously done through open thoracotomy. As the refinement of video technology has advanced, thoracoscopic surgery has played a very important role in thoracic surgery especially since the early 1990s. Because the advantages of video-assisted thoracoscopic surgery for patients include low post-thoracotomy-related morbidity, cosmetic considerations, low pain, earlier post-operative mobilization, and a shorter operation time in some indications, surgeons have been demonstrating its increasing utility in the diagnosis and treatment of the pleura, lung, mediastinum, great vessels, pericardium, and oesophagus. The most common application of the thoracoscopic approach still remains in the management of pleuropulmonary disease. The indications for the thoracoscopic technique are very broad, but its role in the management of primary lung and oesophageal cancer has yet to be confirmed. Thus, the surgeon who uses the technique in these cancerous diseases should be prudent. In conclusion, these thoracoscopic procedures will play more important roles in the practice of thoracic surgery in the future.

Humans↗