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Video Assisted Thoracic
Surgery (VATS) Lobectomy,
Lymphadenectomy and
Segmentectomy for Lung Cancer

May 19, 2009
7:00 pm EDT / 6:00 pm CDT
5:00 pm MDT / 4:00 pm PDT
Your Time:

On Tuesday, May 19, 2009 at 7:00 p.m. EDT, join thoracic surgeons, Dr. Scott Swanson and Dr. Daniel Miller, for a live webcast, including a discussion of surgical techniques used in Video Assisted Thoracic Surgery (or VATS) for lung cancer. The webcast will address the particular technical challenges of Right Lower Lobectomy, Left Upper Lobectomy, and Left-sided and Right-sided Lymphadenectomy and Segmentectomy. The one-hour presentation will feature video segments of the surgeries performed and selected by the panel. The webcast will also feature didactic and question and answer segments presented by the surgeons.

Presenters:

Scott James Swanson, MD, FACS
Director, Minimally Invasive Thoracic Surgery
Brigham and Women's Hospital
Chief Surgical Officer
Dana-Farber/Brigham and Women's Cancer Center
Boston, MA

Daniel L. Miller, MD, FACS
Chief of General Thoracic Surgery
Emory Healthcare, Atlanta, GA
Kamal A. Mansour Professor of Thoracic Surgery
Emory University School  MORE...
On Tuesday, May 19, 2009 at 7:00 p.m. EDT, join thoracic surgeons, Dr. Scott Swanson and Dr. Daniel Miller, for a live webcast, including a discussion of surgical techniques used in Video Assisted Thoracic Surgery (or VATS) for lung cancer. The webcast will address the particular technical challenges of Right Lower Lobectomy, Left Upper Lobectomy, and Left-sided and Right-sided Lymphadenectomy and Segmentectomy. The one-hour presentation will feature video segments of the surgeries performed and selected by the panel. The webcast will also feature didactic and question and answer segments presented by the surgeons.

Presenters:

Scott James Swanson, MD, FACS
Director, Minimally Invasive Thoracic Surgery
Brigham and Women's Hospital
Chief Surgical Officer
Dana-Farber/Brigham and Women's Cancer Center
Boston, MA

Daniel L. Miller, MD, FACS
Chief of General Thoracic Surgery
Emory Healthcare, Atlanta, GA
Kamal A. Mansour Professor of Thoracic Surgery
Emory University School of Medicine, Atlanta, GA

VATS Lobectomy
Over the past decade, VATS Lobectomy has emerged as a minimally invasive alternative to Thoracotomy for lung cancer. Since the surgery is performed thoracoscopically, lung cancer patients receiving a VATS Lobectomy may experience less pain, less morbidity and shorter hospital stays than with the traditional approach. The VATS technique however, can present some unique technical challenges for novice and experienced thoracic surgeons alike. During the one-hour webcast presentation, thoracic surgeons will hear some real-life strategies for addressing these challenges, including patient positioning, accessing critical structures, controlling bleeding, and navigating around major blood vessels. According to Dr. Scott Swanson of Brigham and Women's Hospital, "We hope to provide specific methodologies for getting from point A to point B –how to get around major pulmonary vessels, for example. We'll also demonstrate practical solutions to technical problems – if you can't see well, don't like the angle, problems of bleeding, and so on."

The expert panel will also provide suggestions for teaching the VATS techniques to surgeons and OR personnel. According to Dr. Daniel Miller of the Emory University School of Medicine, "This is a process in learning that will help surgeons and OR personnel to evolve technically. We'll provide a timeline for learning the VATS techniques and strategies for adapting the learning process to the OR." The presentation will further provide information regarding indications for VATS lobectomy, advantages of selecting VATS over thoracotomy, and the ideal candidate for VATS. Equipment selection and application for stabilizing the various blood vessel types during VATS surgery, including the application of Harmonic® and Echelon™ technologies, will also be discussed.

Left-sided and Right-sided Lymphadenectomy
Video-assisted surgical techniques allow for minimally invasive access, isolation, and dissection of the lymph nodes for cancer staging and treatment. The presentation will focus on Left-sided and Right-sided Lymphadenectomy during a VATS lobectomy. Practical strategies for isolating and dissecting the lymph nodes, as well as equipment selection and application, will be discussed during the webcast. Methods for improving visualization when faced with difficult anatomy and/or pathology will also be addressed.

VATS Segmentectomy
With the increased use of computerized tomography (CT) scanning, lung cancers are now found at smaller sizes than in the past. In addition the epidemiology of lung cancer is changing such that they are found more peripherally in the lung. These two situations have focused a renewed interest on the use of anatomic segmental resection (segmentectomy) for lung cancer. Preserving lung tissue will provide the patient with superior lung function when compared with a lobectomy and allow more options for treatment should a second lung cancer develop in the future. Currently a large randomized intergroup study (CALGB 140503) is ongoing to evaluate segmentectomy versus lobectomy for small (< 2 cm) non-small lung cancers. The concept is very similar to the evolution of surgical resection for breast cancer from mastectomy to lumpectomy as the size of the diagnosed breast cancers became smaller over time. A pulmonary segmentectomy requires the dissection, control and division of the individual segmental veins, arteries and bronchus as well as creation of the segmental fissure. The operation is more technically challenging than a lobectomy. However, it is similar to lobectomy in that it is very amenable to a VATS approach affording the patient the same significant benefits over thoracotomy. The sequence of maneuvers including positioning, incision placement, exposure, dissection and division of the segmental structures, creation of the fissure and comprehensive node dissection will be clearly demonstrated on video for a VATS segmentectomy.

On Tuesday, May 19, 2009 at 7:00 p.m. EDT, join surgeons, Dr. Scott Swanson and Dr. Daniel Miller, for this informative webcast live from Boston, Massachusetts. Viewers may send their questions to the surgeons at any time up to, and during, the live webcast by clicking the Ask a Question button on your webcast screen.

This procedure will include demonstration of the use of surgical devices such as the ENDOPATH® Echelon™ stapler and Harmonic® technology; it is not intended to be used as a surgical training guide. Other surgeons may employ different techniques. Individual surgeon preference and experience, as well as patient needs, should always dictate variation in procedure steps. Before using any medical device, including those demonstrated or referenced in this presentation, review all relevant package inserts, with particular attention to the indications, contraindications, warnings and precautions, and steps for use of the device.

This program is presented by Ethicon Endo-Surgery, Inc.

DSL 09-0367.09 ©2009

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