Thoracoscopic lobectomy

  I. Indications for thoracoscopic surgery 1. non-small cell lung cancer (clinical stage I) 2. benign lung disease Pulmonary inflammatory pseudotumor Bronchiectasis Pulmonary aspergillosis Pulmonary isolation disease Tuberculosis bulb Pulmonary cysts II. advantages of thoracoscopic surgery 1. postoperative pain is significantly reduced; one of the advantages of thoracoscopic surgery is that it reduces the postoperative pain of patients and reduces the dosage and application time of postoperative analgesic drugs for patients . The postoperative pain in thoracic surgery is mainly related to rib propping, so thoracoscopic lobectomy without rib propping is more in line with the requirements of minimally invasive surgery; the surgical incisions are 2 incisions of about 1.5 cm and an incision of about 3.5-4.5 cm in length at the position of the 4th intercostal anterior axillary line.  2.Shorten the chest tube placement time and hospitalization time; 3.Comparison of lung function condition and mobility: thoracoscopic surgery preserves the integrity of the thorax and the patient’s respiratory function to a great extent compared with conventional open-chest surgery because the chest wall muscles are not cut and the ribs are not propped up, so the patient’s postoperative lung function condition and mobility are better than those of conventional open-chest surgery patients.  Mediastinal lymph node dissection in thoracoscopic lung cancer surgery can fully achieve the level of mediastinal lymph node dissection in open thoracotomy.  IV. Costs Since only disposable instruments under lumpectomy can be used to cut off large blood vessels and bronchi under thoracoscopy, the cost is about 10,000 yuan higher than that of traditional open-chest surgery, and the cost of this extra instrument is not covered by medical insurance reimbursement.  V. Current development of thoracoscopic lobectomy in our department The level of thoracoscopic lobectomy in our department is at an advanced level in the province, and thoracoscopic lobectomy accounts for more than 50% of lung surgery. For small nodules or hairy glass-like lesions (GGO) in the lung, it is difficult to locate them intraoperatively. We have carried out the preoperative Hookwire smart localization under CT guidance earlier in China, and found the nodules precisely intraoperatively and performed lung segment or lobectomy with satisfactory results and achieved good social benefits.