New directions and technologies for minimal invasive thoracic surgery

Since the use of video-assisted thoracoscopic technique and refinement of related endoscopic instruments, minimal invasive thoracic surgery has developed vary rapidly in the management of various kinds of thoracic and cardiovascular diseases. Until now, minimal invasive thoracic surgery is not just an alternative to thoracotomy or sternotomy, but has become a standard in the treatment of many cardiothoracic diseases. In the recent meeting of The 11^th Asia Pacific Congress of Endoscopic and Laparoscopic Surgery (ELSA) in Taipei on November 21-24, 2013, we invited many physicians, surgeons, and anesthesiologists to share about their experiences in the development of new concepts, refinement of new technologies, and collaboration of multiple disciplines for minimal invasive thoracic surgery.

This special issue of the Journal of Thoracic Disease extends the ideas, presentations, and discussions of this exciting meeting to provide a comprehensive overview on a variety of aspects related to the recent advances in minimal invasive thoracic surgery, with a special emphasis on the nonintubated anesthetic techniques (1-4). Through the articles, readers can have a clear idea regarding the initiation and implementation, as well as the current indications and future perspectives of this novel technique. As for the evolving techniques of thoracoscopic surgery, single-port and natural orifice surgery will definitely play important roles in the near future (5,6). And thoracoscopic surgery can be an effective alternative to thoracotomy in situations such as systematic lymphadenectomy for lung cancer and reoperation for postoperative recurrent primary spontaneous pneumothorax (7,8). Finally, the current status and personal experience of video-assisted or robotic-assisted cardiac surgery are also provided (9,10).

I am grateful to our guest speakers and invited authors who have shared their expertise and contributed diverse and comprehensive knowledge for this excellent issue. With new technologies and refined instruments, it is time to reconsider the new directions of minimal invasive thoracic surgery.

References

1. Hung MH, Hsu HH, Cheng YJ, et al. Nonintubated thoracoscopic surgery: state of the art and future directions. J Thorac Dis 2014;6:2-9.
2. Yang JT, Hung MH, Chen JS, et al. Anesthetic consideration for nonintubated VATS. J Thorac Dis 2014;6:10-3.
3. Chen KC, Cheng YJ, Hung MH, et al. Nonintubated thoracoscopic surgery using regional anesthesia and vagal block and targeted sedation. J Thorac Dis 2014;6:31-6.
4. Cuo Z, Shao W, Yin W, et al. Analysis of feasibility and safety of complete video-assisted thoracoscopic resection of anatomic pulmonary segments under non-intubated anesthesia. J Thorac Dis 2014;6:37-44.
5. Liu CY, Lin CS, Shih CH, et al. Single-port video-assisted thoracoscopic surgery for lung cancer. J Thorac Dis 2014;6:14-21.
6. Liu YH, Chu Y, Wu YC, et al. Natural orifice surgery in thoracic surgery. J Thorac Dis 2014;6:61-3.
7. Wang W, Yin W, Shao W, et al. Comparative study of systematic thoracoscopic lymphadenectomy and conventional thoracotomy in resectable non-small cell lung cancer. J Thorac Dis 2014;6:45-51.
8. Chou SH, Li HP, Lee YL, et al. Video-assisted thoracoscopic surgery for postoperative recurrent primary spontaneous pneumothorax. J Thorac Dis 2014;6:52-5.
9. Chiu KM, Chen RJ. Videoscope-assisted cardiac surgery. J Thorac Dis 2014;6:22-30.
10. Chi NH, Huang CH, Huang SC, et al. Robotic mitral valve repair in infective endocarditis. J Thorac Dis 2014;6:56-60.

Disclosure: The author declares no conflict of interest.