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WJOLS


                                Comparing Task Performance and Comfort during Nonpulmo nary Video-assisted Thoracic Surgery

          is used for retraction only and not for other manipulations.  •  There should be caution when translating this data to
          When used for other purposes, the mirror image produced   humans as the swine models have some peculiarities,
          will lead to reduced task performance and increase surgeon’s   such as flimsy tissues and shortened space between the
          discomfort.                                            anterior and posterior axillary lines.
                                                              •  Surgical simulation using animal models is a high fide lity
          CONCLUSION                                             method and should be encouraged when ever feasible.
          The BDP is the conventional principle used to decide sites   •  An alternative to the swine models should be considered
          for port placement during VATS. The TTP was introduced   for VATS procedures. The sheep models have stronger
          as an alternative principle when difficulty was observed     tissues and are an option.
          during some procedures using the BDP especially pulmonary   REFERENCES
          procedures. This thesis compares the two principles during
          VATS pericardial window, VATS esophagocardiomyotomy     1.  De Silva Mc, Swanson SJ. Video-assisted thoracic surgery in
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          formance in terms of the execution time and error rates and   Jaypee Brothers Medical Publishers (P) limited, New Delhi,
          has less surgeons discomfort during some nonpulmonary   India; 2013.
          VATS procedures in swine models compared to the TTP     3.  landreneau RJ, Mack MJ, Hazelrigg SR, Dowling RD, Acuff
          when stapling is not required.                          TE, Magee MJ, Ferson PS. Video-assisted thoracic surgery:
                                                                  basic technical concepts and intercostal approach strategies.
             The TTP may offer more advantages when the instrument   Ann Thorac Surg 1992;54(4):800-807.
          passed through the target port is used only for retraction and     4.  landreneau RJ, Mack MJ, Keenan RJ, Hazelrigg SR, Dowling RD,
          also in VATS procedures where stapling may be required.  Ferson PS. Strategic planning for video-assisted thoracic surgery.
                                                                  Ann Thorac Surg 1993;56(3):615-619.
             The prolonged execution time associated with BDP     5.  Denny Tl. Video-assisted thoracic surgery. lands bioscience.
          during VATS esophagocardiomyotomy and VATS thoracic     Georgetown, Texas, USA; 2001.
          sympathectomy needs further evaluation with a large data.    6.  Sasaki M, Harai S, Kawabe M, Uesaka T, Morioka K, Ihaya A,
                                                                  Tanaka K. Triangle target principle for trocar placement during
          RECOMMENDATIONS                                         video-assisted thoracic surgery. european J cardiothoracic Surg
                                                                  2005;27(2):307-312.
          •  The BDP should be preferred during nonpulmonary     7.  Operational guidelines for observance of good practices in cPc-
             VATS procedures when stapling may not be required.   SeA. An Indian committee for the purpose of promotion and
          •  The TTP should be preferred during nonpulmonary VATS   supervision of experiments on animals (CPCSEA) document.
             procedures when the instrument through the target port   Available at: www.envfor.nic.com
             is used only for retraction or stapling will be required.    8.  Mayhew PD. Thoracoscopy: basic principles, anaesthetic con-
                                                                  cerns, instrumentation and thoracic access. compendium: conti -
          •  There is need for a larger sample size to have a more   nuing education for veterinarians. 2013 Jan. Available at: www.
             reproducible and validated result.                   vetlearn.com.































          World Journal of Laparoscopic Surgery, May-August 2014;7(2):60-65                                 65
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