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2020 ADVANCED COURSE
Advanced Thoracic Surgery Course - VATS and RATS

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Thoracoscopic Surgery

20
CVS
TPPT

Advanced Thoracic Surgery Course
VATS and RATS


COURSE OBJECTIVES

More and more surgeons are showing interest in advanced video-assisted thoracoscopic procedures, yet many of them are still unsure of how to embark on this challenging program.
The aim of this course is to go into technical details, tips and tricks and to share experience with experts. As thoracoscopic surgery presents a wide range of operative possibilities, with options such as hybrid video-assisted techniques or pure endoscopic ones, international experts in these different approaches will share their experience and discuss the pros and cons of each technique.
For participants interested in training, hands-on sessions on live tissue (option B), as well as initiation on robots (option B) are organized.
The program does not focus on theoretical aspects of advanced thoracoscopic procedures that can be easily found in congresses, such as theoretical background of VATS, benefits and limitations of VATS, analysis of results, controversies about indications...

HIGHLIGHTS

- Technological aspects: the course will focus on practical technological aspects such as instrumentation, energy source and tissue approximation technologies,operating room set-up, robotics.
- Approaches: use and location of access incisions, their benefits and limitations.
- Tips and tricks.
- Complications: one major session of the course will be devoted to the analysis and management of complications, based on videos.

TARGET AUDIENCE

This curriculum is designed to meet the requirements of experienced thoracoscopic surgeons, who are considering starting a VATS program and who seek practical and helpful information. Fellows and residents as well as thoracic surgeons with limited experience in advanced thoracoscopic procedures will also benefit from sharing their experience with experts and colleagues.

Please select a date

COURSE OBJECTIVES

  • To cover a broad spectrum of surgical procedures in VATS and RATS procedures
  • To provide indications for surgical treatment and discuss operative complications
  • To allow for a real-time discussion between experts and trainee surgeons
  • To provide hands-on sessions to improve skills in VATS / RATS surgery through practice on live tissue (mini-pigs) or anatomical specimens under expert tutorial
  • To describe postoperative clinical results and practical applications of evidence-based clinical medicine

EDUCATIONAL METHODS

  • Interactive theoretical and video sessions between Faculty and course participants
  • Pre-recorded operative demonstrations
  • Training on live tissue (mini-pigs) or anatomical specimens under expert tutorial

TARGET AUDIENCE

thoracic surgeons, cardio-thoracic surgeons, pediatric surgeons, general surgeons

COURSE DIRECTORS

J.M. Baste (F) - D. Gossot (F)

FACULTY PANEL

K. Amer (UK), T. Batchelor (UK), F. Becmeur (F), E. Brian (F), H. Decaluwé (B), T.L. Demmy (USA), J. Dunning (UK), M. Durand (F), R. Flores (USA), D. Gonzalez Rivas (SP), C.C Huang (TW), S. Jheon (KOR), T. Kohno (J), F. Melfi (I), C. Peillon (F), R. Petersen (DK), A. Seguin-Givelet (F), A. Sihoe (HK), S. Swanson (USA), M. Tedde (BR), P.A. Thomas (F), W. Walker (UK), J.M. Wihlm (F), H.S. Wu (TW)

COURSE PROGRAM

THURSDAY OCTOBER 14

FOR OPTION A, B AND C
8.00 AM Registration and welcoming of participants

8.30 AM THEORETICAL SESSION
VATS
Prerequisites for advanced thoracoscopic procedures
  • Instrumentation and imaging system
  • Electromagnetic endobronchial navigation: applications for VATS major pulmonary resections
  • Preoperative modeling: applications for VATS major pulmonary resections
VATS : One name - different techniques
The rationale fundamentals for various approaches
  • Thoracoscopic anterior approach
  • Thoracoscopic posterior approach
  • Single port technique
  • Subxiphoid approach
VIDEO SESSION
VATS : Tips & tricks
  • Exposure
  • Vascular control
  • Fissure and parenchymal division
Thoracoscopic lobectomies (Part 1)
VATS : Main technical steps, tips and tricks with different standpoints
  1. Lower lobectomy
  2. Right upper lobectomy (RUL)
  3. Left upper lobectomy (LUL)
12.30 PM Lunch at the Institute

FOR OPTION A, B AND C
1.30 PM VIDEO SESSION
Thoracoscopic lobectomies (Part 2)
VATS & RATS
  • Middle lobectomy
  • Lymph node dissection
  • Sublobar resections
FOR OPTION B AND C  (Option A: afternoon free)
3.00 PM PRACTICAL SESSION: TRAINING ON LIVE TISSUE (MINI-PIGS)
VATS procedures
  • Fissure completion
  • Incision and opening of the mediastinal pleura overlying the left lung hilum
  • Dissection of the common pulmonary vein and cranial lobar vein
  • Division of the cranial lobar vein with linear autostaplers or vessel-sealing devices
  • Dissection and division of the cranial lobar bronchus with linear autostaplers
  • Dissection of the pulmonary arteries one by one and dividing them with linear autostaplers or vessel-sealing devices
  • Left caudal lobectomy
6.30 PM End of session

FRIDAY OCTOBER 15

FOR OPTION A, B AND C
8.00 AM Evaluation of the previous day

8.20 AM THEORETICAL AND VIDEO SESSION
RATS
  • Introduction to the course
  • History of RATS
  • Evidence-based medicine: review of the literature
RATS: Major lung resections
  • Right upper lobectomy (RUL): my operative strategy (3 arms, 4 arms, robotic stapler)
  • Right lower lobectomy (RLL)
  • Right middle lobectomy (RML)
  • Left upper lobectomy (LUL)
  • Left lower lobectomy (LLL)
RATS: Advanced cases
  • Bronchoplasties
  • Upper sulcus tumor
  • Segmentectomies
RATS: Uniportal technique: where do we stand?

RATS: Technological perspectives

RATS: Mediastinal resections
  • Thymectomy: different approaches and indications
  • Complex anterior resections
  • Posterior mediastinal mass resections
  • Robotic esophageal resections
12.30 PM Lunch at the Institute

FOR OPTION A, B AND C
1.30 PM  VIDEO SESSION
Thoracoscopic thymectomies
VATS and RATS
  1. Left approach
  2. Right approach
  3. Bilateral approach
  4. Subxiphoid approach
  5. The robotic surgeon's standpoint
  6. Repairing the phrenic nerve
3.00 PM (Option A: afternoon free)
FOR OPTION B
PRACTICAL SESSION: TRAINING ON LIVE TISSUE (MINI-PIGS)
VATS procedures
  • Fissure completion
  • Incision and opening of the mediastinal pleura overlying the left lung hilum
  • Dissection of the common pulmonary vein and cranial lobar vein
  • Division of the cranial lobar vein with linear autostaplers or vessel-sealing devices
  • Dissection and division of the cranial lobar bronchus with linear autostaplers
  • Dissection of the pulmonary arteries one by one and dividing them with linear autostaplers or vessel-sealing devices
  • Left caudal lobectomy
FOR OPTION C
PRACTICAL SESSION: TRAINING ON ANATOMICAL SPECIMENS
RATS procedures
  • RATS right upper lobectomy (RUL)
  • 4-arm techniques with or without robotic stapler
  • RATS thymectomy (if possible after major lung resection)
  • RUL sleeve resection (if advanced team)
6.30 PM End of session

8.00 PM Dinner in honor of the participants

SATURDAY OCTOBER 17

FOR OPTION A, B AND C
7.45 AM Evaluation of the previous day

8.00 AM THEORETICAL SESSION
LECTURE: Pediatric thoracoscopic surgery

Complications in VATS & RATS
Segmentectomies
  • Basics
  • VATS segmentectomies
  • RATS segmentectomies
Troubleshooting complications in VATS and RATS surgery: description, management and prevention
My complications: How many? What happened? How did I manage them? Which take-home message?

12.00 PM
Lunch-buffet at the institute
End of course
Delivery of certificates of attendance
Program may be subject to modifications

COURSE PROGRAM

THURSDAY OCTOBER 14

FOR OPTION A, B AND C
8.00 AM Registration and welcoming of participants

8.30 AM THEORETICAL SESSION
VATS
Prerequisites for advanced thoracoscopic procedures
  • Instrumentation and imaging system
  • Electromagnetic endobronchial navigation: applications for VATS major pulmonary resections
  • Preoperative modeling: applications for VATS major pulmonary resections
VATS : One name - different techniques
The rationale fundamentals for various approaches
  • Thoracoscopic anterior approach
  • Thoracoscopic posterior approach
  • Single port technique
  • Subxiphoid approach
VIDEO SESSION
VATS : Tips & tricks
  • Exposure
  • Vascular control
  • Fissure and parenchymal division
Thoracoscopic lobectomies (Part 1)
VATS : Main technical steps, tips and tricks with different standpoints
  1. Lower lobectomy
  2. Right upper lobectomy (RUL)
  3. Left upper lobectomy (LUL)
12.30 PM Lunch at the Institute

FOR OPTION A, B AND C
1.30 PM VIDEO SESSION
Thoracoscopic lobectomies (Part 2)
VATS & RATS
  • Middle lobectomy
  • Lymph node dissection
  • Sublobar resections
FOR OPTION B AND C  (Option A: afternoon free)
3.00 PM PRACTICAL SESSION: TRAINING ON LIVE TISSUE (MINI-PIGS)
VATS procedures
  • Fissure completion
  • Incision and opening of the mediastinal pleura overlying the left lung hilum
  • Dissection of the common pulmonary vein and cranial lobar vein
  • Division of the cranial lobar vein with linear autostaplers or vessel-sealing devices
  • Dissection and division of the cranial lobar bronchus with linear autostaplers
  • Dissection of the pulmonary arteries one by one and dividing them with linear autostaplers or vessel-sealing devices
  • Left caudal lobectomy
6.30 PM End of session

FRIDAY OCTOBER 15

FOR OPTION A, B AND C
8.00 AM Evaluation of the previous day

8.20 AM THEORETICAL AND VIDEO SESSION
RATS
  • Introduction to the course
  • History of RATS
  • Evidence-based medicine: review of the literature
RATS: Major lung resections
  • Right upper lobectomy (RUL): my operative strategy (3 arms, 4 arms, robotic stapler)
  • Right lower lobectomy (RLL)
  • Right middle lobectomy (RML)
  • Left upper lobectomy (LUL)
  • Left lower lobectomy (LLL)
RATS: Advanced cases
  • Bronchoplasties
  • Upper sulcus tumor
  • Segmentectomies
RATS: Uniportal technique: where do we stand?

RATS: Technological perspectives

RATS: Mediastinal resections
  • Thymectomy: different approaches and indications
  • Complex anterior resections
  • Posterior mediastinal mass resections
  • Robotic esophageal resections
12.30 PM Lunch at the Institute

FOR OPTION A, B AND C
1.30 PM  VIDEO SESSION
Thoracoscopic thymectomies
VATS and RATS
  1. Left approach
  2. Right approach
  3. Bilateral approach
  4. Subxiphoid approach
  5. The robotic surgeon's standpoint
  6. Repairing the phrenic nerve
3.00 PM (Option A: afternoon free)
FOR OPTION B
PRACTICAL SESSION: TRAINING ON LIVE TISSUE (MINI-PIGS)
VATS procedures
  • Fissure completion
  • Incision and opening of the mediastinal pleura overlying the left lung hilum
  • Dissection of the common pulmonary vein and cranial lobar vein
  • Division of the cranial lobar vein with linear autostaplers or vessel-sealing devices
  • Dissection and division of the cranial lobar bronchus with linear autostaplers
  • Dissection of the pulmonary arteries one by one and dividing them with linear autostaplers or vessel-sealing devices
  • Left caudal lobectomy
FOR OPTION C
PRACTICAL SESSION: TRAINING ON ANATOMICAL SPECIMENS
RATS procedures
  • RATS right upper lobectomy (RUL)
  • 4-arm techniques with or without robotic stapler
  • RATS thymectomy (if possible after major lung resection)
  • RUL sleeve resection (if advanced team)
6.30 PM End of session

8.00 PM Dinner in honor of the participants

SATURDAY OCTOBER 17

FOR OPTION A, B AND C
7.45 AM Evaluation of the previous day

8.00 AM THEORETICAL SESSION
LECTURE: Pediatric thoracoscopic surgery

Complications in VATS & RATS
Segmentectomies
  • Basics
  • VATS segmentectomies
  • RATS segmentectomies
Troubleshooting complications in VATS and RATS surgery: description, management and prevention
My complications: How many? What happened? How did I manage them? Which take-home message?

12.00 PM
Lunch-buffet at the institute
End of course
Delivery of certificates of attendance
Program may be subject to modifications