Surgery Intern – Lung Lobectomy

Study questions

  1. Describe positioning of the patient that facilitates VATS lung lobectomy.
  2. What disposable item can be used for to perform lung biopsies?
  3. List 2 devices that can be used for one lung ventilation.
  4. What is the purpose of one lung ventilation?
  5. The Arndt blocker adapter has 3 ports.  Describe which port is used for the bronchoscope, blocker and anesthesia circuit.
  6. Why is it challenging to block the right lung?
  7. What are complications can be associated with use of the Arndt blocker?
  8. What can be done if the Arndt blocker cannot be removed after a lung lobe has been stapled and how can this be prevented?
  9. What can be done to accelerate collapse of the blocked lung lobe?
  10. What other modality can be used besides a endo-bronchial blocking to increase the working space within the chest?
  11. What imaging modality is invaluable in decision making for VATS lung lobectomy?
  12. Study the CT anatomy of the chest and be able to identify each lung lobe based on bronchial patterns and all bronchial lymph nodes.
  13. What structure needs to be divided to help isolate the hilus of a caudal lung lobe?
  14. Describe the anatomy of the pulmonary ligament of the accessory lung lobe?
  15. What is the closed leg length of endo-GIA stapler that is the tan colored medium vascular tri-staple?  The purple tri-staple?
  16. How does the tri-staple versus standard endo-GIA stapler technology differ?
  17. What is the advantage of the curved tip end-GIA stapler?
  18. What is an articulated versus straight endo-GIA stapler?
  19. If a standard endo-GIA stapler is used what size is used and what color is the cartridge?
  20. How many rows of staples are fired with the endo-GIA?
  21. What is an ideal port for the camera with VATS for a caudal versus a cranial lung lobe?
  22. What port position is riskier for breakage of the endoscope?
  23. What can be used to retrieve the excised lung lobe safely?
  24. What is the size ratio of the mini-thoracotomy to remove the excised lung with its mass?
  25. What complications may be associated with VATS lobectomy?
  26. What dye can be used to identify sentinel lymph nodes within the chest?

VATS lung lobectomy

Below is a video on the Arndt endobronchial blocker

Below is a lecture on VATS lung lobectomy by Dr. Eric Monnet

https://youtu.be/DG7WxLRQsHk

Below is a 2 hour lecture on VATS lung lobectomy – Veterinary Endoscopic Society; click on it below to view in YouTube.com