The Review Of Thoracoscopy Surgery Application And Its Perspective Prospect

Video assisted thoracic operation is an brand-new operation thatwas emerged in 90s last century. It is an newly emerging technology,it was integrated optics technology with hypes-precision, imagingsystem with high definition and endoscopic instruments with hightechnology;it preoperation,anesthesia methods and fundmentalperformance skills are different from orthodox thoracoscope andmore advanced than it. Its scope of clinical application andtherapeutic efficacy are far more exceed than thoracoscope. Modern video assisted thoracic operation have a lot of merits,including;1. less trauma, 2. less pain, 3. lower of complications., 4.recovery faster, 5. fit for cosmetology;otherwise, the televisionimaging system improve the "eyesight" and "sight", convenience ofmatching in the operation;the endoscopic instruments with hightechnology improve the quality of the operation and saving the time. The application scope of the video assisted thoracic operationalmost involve in all kinds of surgery domains, including thoracicsurgery, cardiac surgery, pediatric surgery, vertebral column surgery,and it can or will could repalce the routine surgery treatments. The traditional methods cannot make sure of the diagnosis ofthe pleural effussion, pleura space-occupying lesion, lung cancer andesophageal carcinomas, because that the specimens is too small todiagnosis or cannot get by the traditional methods, so the treatmentcannot carry out. But the video assisted thoracic operation can do itin very small trauma, clinical practice testified that it can highlyimprove the diagnosis rate.Because of the high relapse rate by closed drainage of thoraciccavity, and the traditional operation have lot of flaws: high trauma,slow recovery and more complications, VATS become the standardoperation of the spontaneous pneumothorax.Treatment of the bullous emphysema by VATS become themain modus operandi gradually in the clinical treatment, more andmore patients get the profits form it, and improve the quality of theirlife.VATS can finish the operation of esophageal carcinomaexcision and liberate the esophagus without opening chest wall. Thiscan decreased highly the attack of the operation, diminish thecomplication, low the operation risk, provide the insurance to makesure the recovery successfully after operation.For progressing haemothorax, rupture of the diaphragm,esophagus,ductus thoracicus,lung and so on, the VATS inemergement can judge the patient's condition rapidly and precisely,avoied delaying the patient's condition because conservativeobservation, and decreased the rate of the exploratory thoracotomy.From the clinical data at present, we believe that pericardialeffusion windowing partial excision to treat pericardial fluid byVATS is an means with security and effectiveness, especiallystubborn malignant pericardial effusion. It not only drainaging thefluidify in the cardial sac to relief the compression which can changehemadynamics, but also can sure the pathological change of thecardial sac. There have a lot of reports that ligation of ductusarteriosus and bypass operation of coronary artery can be finished byVATS.In the domain of the vertebral column surgery, VATS also canhelp doctor to finish plenty of operations : for instance, the abscessdrainage of the disci intervertebrales, biopsy of disci intervertebralesor body of vertebra, excision of the intervertebral disk hernia,rectification of the scoliosis, bone graft mixing of the intervertebraldisc space. With the improvement of the endoscopic instruments andthe clinical experience accumulation, more chirurgeon knowingabout this tecnology, the VATS will enlarge its range of scope.VATS have made a huge progresses in 20 years recently, but itcan not replace the standard traditional thoracic surgery. It have itsown limitions: 1) need high anesthetic skills. tracheal intubationswith double cavitas intubation, pulmonary collapse of the operationside is needed. And the patients with low heart store function whomcan not bear the half lung ventilation is not fit for this technology. 2)when the extent of disease is far, VATS have limits;3) the VATScan enter into the thoracic cavity when the adherence is generally.4) to many patients with malignant tumor ,the range of the excisionunder VATS cannot make the treatment effectiveness satisfy. 5) thecharge is expensive.In our country, although it progressed rapidly, because it staredlater than advanced countries, the use of the VATS have a hugh gapcompare to it. The reasons are the fee is high, the work of konwingand spreading this technology is not well. Only the chirurgeonmaster the skills and make progress in operation, the range scope ofapplication can expended. This need a set of good traininginstallation and system, establishing related organization to promotethe skill interchange, from these measures, more and morechirurgeon can know,master and utilize this technology.