tochii sachiko

We retrospectively assessed the utility of continuous paravertebral block in patients undergoing thoracoscopic lung resection. Among 92 consecutive patients, 32 received additional paravertebral block (PVB group) with 0.2% Ropivacaine hydrochloride hydrate, continuous at a rate of 3 ml/h for 3 days starting immediately after surgery. All patients received oral NSAIDS for baseline pain relief and either a rescue dose of Diclofenac sodium at 50 mg enterally or Pentazocine at 15 mg intravenously when necessary. Pain was assessed using a visual analogue scale, with 0 representing no pain and 100 for the worst pain possible. Intraoperative thoracoscopic catheterization was straightforward, and there were no complications associated with paravertebral block. The mean pain score within the first 2 days following surgery was significantly lower in the PVB group (28±16 vs. 43±18, p<0.01). The total doses of the abovementioned rescue analgesics were both lower in the PVB group. Continuous paravertebral block is a simple, safe, and effective method of postoperative analgesia in patients undergoing thoracoscopic lung resection.

The da Vinci Surgical System is a telerobotic system consisting of 4 components, including the Insite vision system with a true 3-dimensional endoscope providing a high-resolution binocular view of the surgical field, and the Endo Wrist instrument system, which is capable of 7 degrees of freedom and 2 degrees of axial rotation to replicate human wrist-like movements. Right upper lobectomy + mediastinal lymph node dissection was performed in a 56-year-old woman with cT1bN0N0 stage IA lung adenocarcinoma. The operating time was 6 hours 48 minutes, and the blood loss was 234 g. The da Vinci Surgical System has useful advantages over conventional VATS surgery concerning the precise dissection of hilar structures and mediastinal lymph nodes. With further innovations in the future, the da Vinci Surgical System has the potential to facilitate technically difficult surgery employing conventional VATS techniques.