Most helpful: Dr. Marco Scarci & Dr. Diego Gonzalez Rivas
For less abstract, and more clinically relevant information, particularly for surgeons new to uniportal VATS, the lectures by both Dr. Marco Scarci and Dr. Diego Gonzalez Rivas were standouts.
Dr. Marco Scarci’s presentation, entitled, “Uniportal VATS: Hilar dissection” was a thorough review of the technical aspects of performing hilar dissection using the uniportal VATS approach.
He began by discussing the basic pitfalls of incorrect port placement. Since there is only one port used, correct placement is essential for good visualization and operative access. A port placed too high makes it impossible to place the stapler intra-operatively. A port placed too low will create an angle too narrow to allow the surgeon to manipulate the hilar vessels.
Dr. Scarci has a standardized approach for each procedure. During his lecture, he reviews a step-by-step approach to a right upper lobectomy with a complete lymph node dissection. He gives concrete, helpful advice with tips and techniques based on experience.
As he explains, in uniportal VATS it’s easier to take lymph nodes during the procedure than to work around them, making a complete and thorough dissection an easy and methodical process. Dr. Scarci gives additional tips for surgeons including:
- Have the proper equipment. A standard right angle doesn’t work well for hilar dissection.
- Don’t rip nodes, use an energy device to avoid unnecessary oozing.
He also discussed addressing, treating and controlling intra-operative errors and complications in a frank, and candid fashion – including the dreaded and feared complication of pulmonary artery injury.
This complication was addressed again in Dr. Diego Gonzalez Rivas’ lecture, “Management of Complications.”
This popular lecture includes a frank discussion on anticipating and managing serious complications, including massive hemorrhage, accidental bronchial injury and pulmonary artery injury.
Kudos too to Dr. Scarci for all the new topics – some from our very own wish list..