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Cancers
Special Issues
Innovative Approaches to Minimally Invasive Surgical Techniques in Thoracic Oncology
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Innovative Approaches to Minimally Invasive Surgical Techniques in Thoracic Oncology

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 3464

Special Issue Editors

Prof. Dr. Joachim Schmidt

E-Mail Website
Guest Editor
1. Department of Thoracic Surgery, Helios Hospital Bonn/Rhein-Sieg, Bonn, Germany
2. Division of Thoracic Surgery, Department of General, Thoracic and Vascular Surgery, Bonn University Hospital, Bonn, Germany
Interests: minimally invasive thoracic surgery; pediatric thoracic surgery; robotic surgery; augmented reality; virtual reality
Dr. Benedetta Bedetti

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Helios Hospital Bonn/Rhein-Sieg, Bonn, Germany
Interests: minimally invasive thoracic surgery; robotic surgery; uniportal surgery
Dr. Philipp Schnorr

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Helios Hospital Bonn/Rhein-Sieg, Bonn, Germany
Interests: minimally invasive thoracic surgery; oncologic thoracic surgery; non-intubated surgery

Special Issue Information

Dear Colleagues,

The development of new technologies is changing the world of surgery, providing innovative tools for diagnostics and interventions. In particular, the application of new tools and techniques in the field of thoracic surgical oncology may improve patients’ outcomes in the short and long term. There are many fields, in which these developments are constantly growing. The best examples are the fields of virtual, mixed, and augmented reality. These new frontiers are developing fast and can be implemented in medical education, pre-operative planning, and intraoperative assistance.

Robotic surgery is another field that is currently evolving and developing new ideas, such as the uniportal robotic arm.

Finally, we must not forget the “traditional” VATS approach: in fact, even if VATS is established worldwide, there is still progress to be made in refining this technique and improving oncologic results.

New developments are also essential in the multimodal treatment of oncologic patients, such as the possibility of using immunotherapy in a neoadjuvant setting.

In this Special Issue of Cancers, we welcome original research articles or comprehensive review articles that focus on development and applications of new approaches in minimally invasive thoracic surgical oncology. We hope that this collection of papers will provide an overview of new perspectives of the future of minimally invasive thoracic surgery.

Prof. Dr. Joachim Schmidt
Dr. Benedetta Bedetti
Dr. Philipp Schnorr
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • minimally invasive thoracic surgery
  • new technologies
  • virtual reality
  • augmented reality
  • robotic surgery

Published Papers (3 papers)

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Research

13 pages, 1372 KiB  
Article
Reduction of Blood Loss by Means of the Cavitron Ultrasonic Surgical Aspirator for Thoracoscopic Salvage Anatomic Lung Resections
by Yu-Hsiang Wang, Stella Chin-Shaw Tsai and Frank Cheau-Feng Lin
Cancers 2023, 15(16), 4069; https://doi.org/10.3390/cancers15164069 - 11 Aug 2023
Viewed by 873
Abstract
In centrally located lung tumors, salvage pulmonary resections pose challenges due to adhesions between the pulmonary parenchyma, chest wall, and hilum. This study aimed to investigate the surgical outcomes associated with Cavitron Ultrasonic Surgical Aspirator (CUSA) usage in thoracoscopic salvage pulmonary resections. Patients [...] Read more.
In centrally located lung tumors, salvage pulmonary resections pose challenges due to adhesions between the pulmonary parenchyma, chest wall, and hilum. This study aimed to investigate the surgical outcomes associated with Cavitron Ultrasonic Surgical Aspirator (CUSA) usage in thoracoscopic salvage pulmonary resections. Patients with centrally located advanced-stage lung tumors who underwent salvage anatomic resections following systemic or radiotherapy were included. They were categorized into CUSA and non-CUSA groups, and perioperative parameters and surgical outcomes were analyzed. Results: The study included 7 patients in the CUSA group and 15 in the non-CUSA group. Despite a longer median surgical time in the CUSA group (3.8 h vs. 6.0 h, p = 0.021), there was a significant reduction in blood loss (100 mL vs. 250 mL, p = 0.014). Multivariate analyses revealed that the use of CUSA and radiotherapy had opposing effects on blood loss (β: −296.7, 95% CI: −24.8 to −568.6, p = 0.034 and β: 282.9, 95% CI: 19.7 to 546.3, p = 0.037, respectively). In conclusion, while using CUSA in the salvage anatomic resection of centrally located lung cancer may result in a longer surgical time, it is crucial in minimizing blood loss during the procedure. Full article
(This article belongs to the Special Issue Innovative Approaches to Minimally Invasive Surgical Techniques in Thoracic Oncology)
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11 pages, 2086 KiB  
Article
Intraoperative Contrast-Enhanced Ultrasonography (Io-CEUS) in Minimally Invasive Thoracic Surgery for Characterization of Pulmonary Tumours: A Clinical Feasibility Study
by Martin Ignaz Schauer, Ernst-Michael Jung, Natascha Platz Batista da Silva, Michael Akers, Elena Loch, Till Markowiak, Tomas Piler, Christopher Larisch, Reiner Neu, Christian Stroszczynski, Hans-Stefan Hofmann and Michael Ried
Cancers 2023, 15(15), 3854; https://doi.org/10.3390/cancers15153854 - 29 Jul 2023
Cited by 1 | Viewed by 833
Abstract
Background: The intraoperative detection of solitary pulmonary nodules (SPNs) continues to be a major challenge, especially in minimally invasive video-assisted thoracic surgery (VATS). The location, size, and intraoperative frozen section result of SPNs are decisive regarding the extent of lung resection. This feasibility [...] Read more.
Background: The intraoperative detection of solitary pulmonary nodules (SPNs) continues to be a major challenge, especially in minimally invasive video-assisted thoracic surgery (VATS). The location, size, and intraoperative frozen section result of SPNs are decisive regarding the extent of lung resection. This feasibility study investigates the technical applicability of intraoperative contrast-enhanced ultrasonography (Io-CEUS) in minimally invasive thoracic surgery. Methods: In this prospective, monocentric clinical feasibility study, n = 30 patients who underwent Io-CEUS during elective minimally invasive lung resection for SPNs between October 2021 and February 2023. The primary endpoint was the technical feasibility of Io-CEUS during VATS. Secondary endpoints were defined as the detection and characterization of SPNs. Results: In all patients (female, n = 13; mean age, 63 ± 8.6 years) Io-CEUS could be performed without problems during VATS. All SPNs were detected by Io-CEUS (100%). SPNs had a mean size of 2.2 cm (0.5–4.5 cm) and a mean distance to the lung surface of 2.0 cm (0–6.4 cm). B-mode, colour-coded Doppler sonography, and contrast-enhanced ultrasound were used to characterize all tumours intraoperatively. Significant differences were found, especially in vascularization as well as in contrast agent behaviour, depending on the tumour entity. After successful lung resection, a pathologic examination confirmed the presence of lung carcinomas (n = 17), lung metastases (n = 10), and benign lung tumours (n = 3). Conclusions: The technical feasibility of Io-CEUS was confirmed in VATS before resection regarding the detection of suspicious SPNs. In particular, the use of Doppler sonography and contrast agent kinetics revealed intraoperative specific aspects depending on the tumour entity. Further studies on Io-CEUS and the application of an endoscopic probe for VATS will follow. Full article
(This article belongs to the Special Issue Innovative Approaches to Minimally Invasive Surgical Techniques in Thoracic Oncology)
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17 pages, 9380 KiB  
Article
Artificial Intelligence-Based Hazard Detection in Robotic-Assisted Single-Incision Oncologic Surgery
by Gabriela Rus, Iulia Andras, Calin Vaida, Nicolae Crisan, Bogdan Gherman, Corina Radu, Paul Tucan, Stefan Iakab, Nadim Al Hajjar and Doina Pisla
Cancers 2023, 15(13), 3387; https://doi.org/10.3390/cancers15133387 - 28 Jun 2023
Cited by 2 | Viewed by 1281
Abstract
The problem: Single-incision surgery is a complex procedure in which any additional information automatically collected from the operating field can be of significance. While the use of robotic devices has greatly improved surgical outcomes, there are still many unresolved issues. One of the [...] Read more.
The problem: Single-incision surgery is a complex procedure in which any additional information automatically collected from the operating field can be of significance. While the use of robotic devices has greatly improved surgical outcomes, there are still many unresolved issues. One of the major surgical complications, with higher occurrence in cancer patients, is intraoperative hemorrhages, which if detected early, can be more efficiently controlled. Aim: This paper proposes a hazard detection system which incorporates the advantages of both Artificial Intelligence (AI) and Augmented Reality (AR) agents, capable of identifying, in real-time, intraoperative bleedings, which are subsequently displayed on a Hololens 2 device. Methods: The authors explored the different techniques for real-time processing and determined, based on a critical analysis, that YOLOv5 is one of the most promising solutions. An innovative, real-time, bleeding detection system, developed using the YOLOv5 algorithm and the Hololens 2 device, was evaluated on different surgical procedures and tested in multiple configurations to obtain the optimal prediction time and accuracy. Results: The detection system was able to identify the bleeding occurrence in multiple surgical procedures with a high rate of accuracy. Once detected, the area of interest was marked with a bounding box and displayed on the Hololens 2 device. During the tests, the system was able to differentiate between bleeding occurrence and intraoperative irrigation; thus, reducing the risk of false-negative and false-positive results. Conclusion: The current level of AI and AR technologies enables the development of real-time hazard detection systems as efficient assistance tools for surgeons, especially in high-risk interventions. Full article
(This article belongs to the Special Issue Innovative Approaches to Minimally Invasive Surgical Techniques in Thoracic Oncology)
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