Minimally invasive videothoracoscopic surgery
Uniportal Videothoracoscopic Surgery
Over the past few decades lung cancer surgery has evolved and reduced its aggressiveness from mayor incisions (wide enough to allow a hand into the chest cavity by means of splitting ribs) towards minimally invasive approaches.
Minimally invasive surgery (videothoracoscopic surgery) employs 2 to 4 wounds of 5-10mm each to enable endoscopic optics and instruments into the thorax in order to achieve a pulmonary resection.
In 2013 a novel approach was first described through uniportal videothoracoscopic surgery. It offers the advantage of performing pulmonary resections by creating only one small incision of 2.5-3cm through which endoscopic instruments are employed. Since its emergence, uniportal videothoracoscopic surgery has been widely recognized and adopted by most thoracic surgery teams.
Uniportal videothoracoscopic surgery is a less aggressive procedure that is directly related with a less painful postoperative period and shorter recovery. It offers the patient the possibility to actively imply oneself in pulmonary physiotherapy to prevent postoperative complications such pneumonias.
Lung cancer
Uniportal videothoracoscopic surgery (minimally-invasive thoracic surgery)
Lung cancer surgery is part of a multi-disciplinary approach where chemo or radiotherapy may be necessary in order to achieve the best survival rate available. The accurate role of surgery in lung cancer depends on the stage at diagnosis.
Lung cancer staging refers to a certain level of the natural evolution of lung cancer at diagnosis. It ranges from stage I (localized) to IV (spread), based on an international classification. Once diagnosed and classified in a stage deemed operable, surgery usually involves removing part of the lung (called lobe).
If the specific conditions of the case grant it, we employ uniportal videothoracoscopic surgery (minimally-invasive thoracic surgery) to remove the target lobe instead of an open procedure.
This less invasive surgical approach offers the advantages of diminishing postoperative pain and accelerating patient´s recovery.
Sweaty hands or axilla (primary palmar/axillar hyperhidrosis), facial blushing
Videothoracoscopic simpathectomy
Excessive sweating of hands or palms is termed palmar hyperhidrosis. This medical condition is an extremely annoying, embarrassing, and confidence-wrecking problem.
Various therapeutic options are available depending on its severity. For mild to moderate forms; antiperspirants, iontophoresis or botox injections (or a custom combination) may suffice. Nevertheless, for intense forms or those looking for a definitive treatment, surgery should be considered.
Surgery for palmar hyperhidrosis implies dividing a nerve that runs inside the chest cavity. This nerve is responsible for carrying the information from or nervous system to the sweaty glands on our palms.
If the specific conditions of the case grant it, we accomplish this procedure by performing only one axillary incision of 1cm on each side (minimally invasive surgery). This less invasive surgical approach offers the advantages of diminishing postoperative pain and accelerating patient´s recovery.
Pneumothorax
Uniportal videothoracoscopic surgery (minimally-invasive thoracic surgery)
If we think of the lung as an inflated balloon inside the thoracic cavity, when a pneumothorax takes place, it determines a collapse of the lung affected (the balloon is popped and deflated) due to a fissure or bleb. Consequently, it stops oxygenating the blood´s patient. This situation is usually associated with short of breath and back pain.
Treatment initially involves the insertion of a catheter inside the chest cavity to regain full expansion of the lung and restart proper oxygenation. Under certain circumstances, pneumothorax needs to be operated.
Surgery of pneumothorax implies to remove small areas of the lung afflicted with fissures or blebs along with a procedure that pursues a firm adhesion between the lung and the inner layer of the chest wall in order to diminish the relapse rate.
If the specific conditions of the case grant it, we employ uniportal videothoracoscopic surgery (minimally-invasive thoracic surgery) instead of an open procedure to remove the target areas of the lung afflicted with fissures or blebs.
This less invasive surgical approach offers the advantages of diminishing postoperative pain and accelerating patient´s recovery.
Mediastinal surgery (myasthenia gravis and thymoma)
Videothoracoscopic thymectomy with CO2 insufflation
The mediastinum refers to an anatomic region that comprises the organs and structures lying in the middle line between our two lungs. It is the origin of several different pathologies including myasthenia gravis, thymoma, brochogenic or pericardial cysts among others.
Mediastinal surgery implies removing all tissue and masses from that space. It was routinely performed by splitting the sternum to allow the hand of the surgeon to access the mediastinum. Nevertheless, nowadays, for the majority of pathologies, the procedure is attained through minimally invasive surgery.
If the specific conditions of the case grant it, we remove the target areas of the mediastinum by videothoracoscopic thymectomy with CO2 insufflation which implies creating only three small incisions to access the chest cavity and fulfill the resection.
This less invasive surgical approach offers the advantages of diminishing postoperative pain and accelerating patient´s recovery.
Pectus excavatum and Poland Syndrome
Customized 3D prosthesis
Treatment of rib cage deformities varies depending on the age of the patient. For those patients under 18 years of age, conservative measures such as Vaccum Bell should be considered. However, for patients who have completed their growth process (> 18 years), the stiffness of the rib cage requires invasive therapeutic alternatives.
Although we have performed invasive surgical techniques for many years (Nuss or Ravitch), we are convinced that customized individualized 3D prostheses achieve highly satisfactory aesthetic results without having to alter the patient’s skeleton or enter organic cavities.
Dr. Arroyo is a reference surgeon in the process of customized individualized 3D prostheses. For more information, please visit: