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Dominique GOSSOT

Institut Mutualiste Montsouris
Paris, France
MD
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Full thoracoscopic left 6 segmentectomy for invasive pulmonary aspergillosis (IPA)
This video summarizes the main steps of a thoracoscopic left S6 segmentectomy whose indication was a high suspicion of invasive pulmonary aspergillosis (IPA) in a female patient presenting with an acute myeloid leukemia. IPA was resistant to antifungal therapy. A resection was rapidly required as an allogenic bone marrow transplantation was pending.
A full thoracoscopic technique, i.e., with access incision, was used. As for all anatomical segmentectomies performed in our department, a tridimensional reconstruction was carried out preoperatively. A high-definition camera system, a deflectable scope, as well as dedicated thoracoscopic instruments were used.
D Gossot, A Seguin-Givelet, E Brian, M Grigoroiu, D Mayeur, J Lutz
Surgical intervention
3 years ago
816 views
40 likes
0 comments
08:39
Full thoracoscopic left 6 segmentectomy for invasive pulmonary aspergillosis (IPA)
This video summarizes the main steps of a thoracoscopic left S6 segmentectomy whose indication was a high suspicion of invasive pulmonary aspergillosis (IPA) in a female patient presenting with an acute myeloid leukemia. IPA was resistant to antifungal therapy. A resection was rapidly required as an allogenic bone marrow transplantation was pending.
A full thoracoscopic technique, i.e., with access incision, was used. As for all anatomical segmentectomies performed in our department, a tridimensional reconstruction was carried out preoperatively. A high-definition camera system, a deflectable scope, as well as dedicated thoracoscopic instruments were used.
Thoracoscopic middle lobectomy with sleeve resection for bulky carcinoid tumor
We report the case of a 35-year-old female patient presenting with hemoptysis from a bulky carcinoid tumor of the middle lobe protruding in the truncus intermedius.
A middle lobectomy with sleeve resection was performed, using a full thoracoscopic approach, i.e. without utility incision. Resection margins were free. The final pathologic examination confirmed a typical pT1bN0carcinoid tumor.
The patient was discharged on postoperative day 4, after an uneventful postoperative course.
The main steps of the procedure are described. The slightly hemorrhagic atmosphere of the operation is due to vascular compression from the tumor.
D Gossot, M Grigoroiu, E Brian
Surgical intervention
5 years ago
815 views
13 likes
0 comments
09:22
Thoracoscopic middle lobectomy with sleeve resection for bulky carcinoid tumor
We report the case of a 35-year-old female patient presenting with hemoptysis from a bulky carcinoid tumor of the middle lobe protruding in the truncus intermedius.
A middle lobectomy with sleeve resection was performed, using a full thoracoscopic approach, i.e. without utility incision. Resection margins were free. The final pathologic examination confirmed a typical pT1bN0carcinoid tumor.
The patient was discharged on postoperative day 4, after an uneventful postoperative course.
The main steps of the procedure are described. The slightly hemorrhagic atmosphere of the operation is due to vascular compression from the tumor.
Thoracoscopic left superior segmentectomy for primary lung adenocarcinoma
This 59-old male patient, smoker, has a previous history of thymoma that was operated upon 15 years ago by sternotomy. He presented with a large nodule in the superior segment of the left lower lobe. Bronchoscopy was normal. A biopsy was performed under CT-scan control and revealed a primary adenocarcinoma TTF1+. 18-FDG scintigraphy showed a significant and isolated fixation. Because of the impaired respiratory function, a limited resection was decided upon, i.e, a resection of the superior segment of the left lower lobe with radical lymph node dissection.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
D Gossot
Surgical intervention
9 years ago
2255 views
14 likes
0 comments
07:01
Thoracoscopic left superior segmentectomy for primary lung adenocarcinoma
This 59-old male patient, smoker, has a previous history of thymoma that was operated upon 15 years ago by sternotomy. He presented with a large nodule in the superior segment of the left lower lobe. Bronchoscopy was normal. A biopsy was performed under CT-scan control and revealed a primary adenocarcinoma TTF1+. 18-FDG scintigraphy showed a significant and isolated fixation. Because of the impaired respiratory function, a limited resection was decided upon, i.e, a resection of the superior segment of the left lower lobe with radical lymph node dissection.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
Endoscopic mediastinal lymph node dissection for stage I lung carcinoma
In this video, we will focus on mediastinal lymph node dissection as defined by the American College of Surgeons Oncology Group, i.e.: for right-sided tumors: removal of all lymphatic tissue bounded by the right upper bronchus, the right subclavian artery, the superior vena cava and the trachea (stations 2R and 4R); for left-sided tumors: removal of all lymphatic tissue bounded by the phrenic nerve, the vagus nerve and the top of the aortic arch (stations 5 and 6); and for both sides, removal of lymph nodes from stations 7, 8, 9, 10 and 11.
A perfect vision is necessary during mediastinal lymph node dissection. An oblique viewing 30 degree scope or a deflectable thoracoscope is almost essential to avoid the drawbacks linked to tangential vision, as it frequently occurs with a low inserted scope.
During open or video-assisted lymphadenectomy, it is usual to control small vessels by a combination of clipping and transection. This is time-consuming and it can be replaced by either bipolar cautery or ultrasonic shears or a vessel-sealing device, which both allow coagulating and transecting with a single tool.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
D Gossot
Surgical intervention
9 years ago
3124 views
17 likes
0 comments
09:36
Endoscopic mediastinal lymph node dissection for stage I lung carcinoma
In this video, we will focus on mediastinal lymph node dissection as defined by the American College of Surgeons Oncology Group, i.e.: for right-sided tumors: removal of all lymphatic tissue bounded by the right upper bronchus, the right subclavian artery, the superior vena cava and the trachea (stations 2R and 4R); for left-sided tumors: removal of all lymphatic tissue bounded by the phrenic nerve, the vagus nerve and the top of the aortic arch (stations 5 and 6); and for both sides, removal of lymph nodes from stations 7, 8, 9, 10 and 11.
A perfect vision is necessary during mediastinal lymph node dissection. An oblique viewing 30 degree scope or a deflectable thoracoscope is almost essential to avoid the drawbacks linked to tangential vision, as it frequently occurs with a low inserted scope.
During open or video-assisted lymphadenectomy, it is usual to control small vessels by a combination of clipping and transection. This is time-consuming and it can be replaced by either bipolar cautery or ultrasonic shears or a vessel-sealing device, which both allow coagulating and transecting with a single tool.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
Totally endoscopic right basilar segmentectomy for stage I lung carcinoma
Pulmonary segmentectomy was originally introduced nearly 70 years ago for the treatment of benign lung conditions. Later, Jensik and colleagues as well as Peters independently suggested that anatomic pulmonary segmentectomy could be effectively applied to small primary lung cancers when good margins were achievable. Today, this is possible thanks to recognition of early lung cancer by high-resolution computed tomography scan. Futhermore, lung-sparing procedures are advocated in those with small, early-stage primary lung cancers so that additional resections for bilateral synchronous or metachronous primaries are facilitated.
Several advantages to endoscopic procedures relative to open procedures have been identified and include decreased postoperative pain, shortened chest tube duration and length of stay, faster return to preoperative activity levels, preserved pulmonary function, and decreased inflammatory response.
This video demonstrates the main steps of a totally endoscopic right basilar segmentectomy for stage I lung carcinoma.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
D Gossot
Surgical intervention
10 years ago
1843 views
25 likes
1 comment
04:14
Totally endoscopic right basilar segmentectomy for stage I lung carcinoma
Pulmonary segmentectomy was originally introduced nearly 70 years ago for the treatment of benign lung conditions. Later, Jensik and colleagues as well as Peters independently suggested that anatomic pulmonary segmentectomy could be effectively applied to small primary lung cancers when good margins were achievable. Today, this is possible thanks to recognition of early lung cancer by high-resolution computed tomography scan. Futhermore, lung-sparing procedures are advocated in those with small, early-stage primary lung cancers so that additional resections for bilateral synchronous or metachronous primaries are facilitated.
Several advantages to endoscopic procedures relative to open procedures have been identified and include decreased postoperative pain, shortened chest tube duration and length of stay, faster return to preoperative activity levels, preserved pulmonary function, and decreased inflammatory response.
This video demonstrates the main steps of a totally endoscopic right basilar segmentectomy for stage I lung carcinoma.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
Totally endoscopic right apico-posterior segmentectomy for stage I lung carcinoma
This is the case of a 56-year-old male patient presenting with stage I (cT1N0) adenocarcinoma of the posterior segment of the right upper pulmonary lobe.
In this case, we will perform a totally endoscopic segmentectomy, namely only video display and endoscopic instrumentation without utility incision. A 3cm incision is made at completion of the segmentectomy by enlarging one of the ports for specimen extraction.
In this video, only the main steps of the pulmonary resection will be demonstrated. The lymphadenectomy will be shown in another video.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
D Gossot
Surgical intervention
10 years ago
1561 views
22 likes
0 comments
06:08
Totally endoscopic right apico-posterior segmentectomy for stage I lung carcinoma
This is the case of a 56-year-old male patient presenting with stage I (cT1N0) adenocarcinoma of the posterior segment of the right upper pulmonary lobe.
In this case, we will perform a totally endoscopic segmentectomy, namely only video display and endoscopic instrumentation without utility incision. A 3cm incision is made at completion of the segmentectomy by enlarging one of the ports for specimen extraction.
In this video, only the main steps of the pulmonary resection will be demonstrated. The lymphadenectomy will be shown in another video.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
Full thoracoscopic lingulectomy
This video illustrates the case of a 54-year-old female patient presenting with a 2cm tumor of the lingula. Percutaneous biopsy under CT-scan guidance revealed a carcinoid tumor. Imaging and DOPA PET scan did not demonstrate any other localization of the disease.

The patient was treated with a lingulectomy and lymphadenectomy performed via a totally endoscopic approach. The specimen was retrieved through one of the port that was enlarged at the end of the procedure. She was discharged 4 days later. Pathological examination confirmed the carcinoid tumor. All 18 removed lymph nodes were benign.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
D Gossot
Surgical intervention
11 years ago
537 views
21 likes
0 comments
05:14
Full thoracoscopic lingulectomy
This video illustrates the case of a 54-year-old female patient presenting with a 2cm tumor of the lingula. Percutaneous biopsy under CT-scan guidance revealed a carcinoid tumor. Imaging and DOPA PET scan did not demonstrate any other localization of the disease.

The patient was treated with a lingulectomy and lymphadenectomy performed via a totally endoscopic approach. The specimen was retrieved through one of the port that was enlarged at the end of the procedure. She was discharged 4 days later. Pathological examination confirmed the carcinoid tumor. All 18 removed lymph nodes were benign.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
Thoracoscopic approach to pericardial effusions
The description of the Thoracoscopic approach to pericardial effusions covers all aspects of the surgical procedure used for the management of (description de la pathologie en cause).
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: Introduction, Anatomy, Indications, Preop period, Operating room set-up, Trocar placement, Instruments, Access/pericardium, Puncture/pericardium, Pericardial opening, Pericardial exploration, Drainage, Complications, Postop period, Reference.
Consequently, this operating technique is well standardized for the management of this condition.
D Gossot
Operative technique
17 years ago
1599 views
51 likes
0 comments
Thoracoscopic approach to pericardial effusions
The description of the Thoracoscopic approach to pericardial effusions covers all aspects of the surgical procedure used for the management of (description de la pathologie en cause).
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: Introduction, Anatomy, Indications, Preop period, Operating room set-up, Trocar placement, Instruments, Access/pericardium, Puncture/pericardium, Pericardial opening, Pericardial exploration, Drainage, Complications, Postop period, Reference.
Consequently, this operating technique is well standardized for the management of this condition.