Recently, 6 senior thoracic surgery physicians from UK, Germany, and Netherland visited West China Hospital to learn minimal invasive thoracic surgery techniques, especially the world’s first single-direction VATS lobectomy technique developed by Professor Liu Lunxu. This training session serves as the first surgical technique training program opened by West China Hospital to thoracic surgery physicians from advanced European countries.
During this one-week program, the minimal invasive VATS lecturer team, led by Professor Liu Lunxu from thoracic surgery department of West China Hospital, Sichuan University, designed an elaborative training scheme. Various teaching methods were adopted, including thematic courses given completely in English, case and therapeutic schedule discussion, practical surgery observation and communication, and teaching rounds, thus allowing the European physicians to master key technical points and standard clinical diagnosis and treatment paths.
Doctor Liu Lunxu, the lead lecturer, is the director of thoracic surgery department of West China Hospital, mainly dealing with studies on integrated clinical treatment solutions for lung cancer and their application basis, minimal invasive thoracic surgeries and application basis, and clinical lung transplantation. He acts as the head supervisor for one National Natural Science Fund, principal investigator for five National Natural Science Funds, and the leader of six provincial and international cooperation (CMB) programs. In 2011, through efforts for nearly ten years, Liu Lunxu invented a novel modern medicine technique: single-direction VATS lobectomy, which won the first prize by unanimous vote in the annual Provincial Scientific & Technical Advancement Award.
Great significance of single-direction VATS lobectomy
Lung cancer is the No. 1 lethal factor in China and a major threat to health of Chinese people. So far surgical treatment of lung cancer has been mainly achieved by means of lobectomy that can take the form of either thoracotomy or thoracoscope (VATS). The traditional thoracotomy surgery tends to lead to severe wound and a lot of complications. In contrast, minimal invasive VATS surgery features smaller wound, more rapid recovery, and fewer complications, which add up to a promising long-term efficacy. However, due to lack of mature VATS lobectomy and lymph node dissection techniques, it is difficult to handle haemorrhage during a VATS operation. Due to this reason, development of VATS has been slow for a long time.
In 2006, a team of West China Hospital, Sichuan University led by Professor Liu Lunxu invented the first single-direction VATS lobectomy across the globe. The critical point of the technique is described as follows: The dissection starts from the most superficial structures at the interface between lungs and the heart without touching the pulmonary parenchyma (the single-point concept). The lung hilum structures are treated in order from shallow to deep ones, and the resection is therefore completed progressively along one direction (the single-direction concept).
A “non-gripping monobloc mediastinal lymph node dissection technique” was developed for VATS as a critical innovation. It provides the advantages of fewer devices required for operation, clearer operative field view, and less lymph node disruption. The team also developed aspirator-guided electric hook sharp dissociation technique and endoscopic bleeding handling technique, thus forming a complete minimal invasive poeumosurgery system.
Comparison of operation results with international data in the same period: The operation time is shorter by 35%. The blood loss is lower by 66%. The transit thoracotomy rate is 2.6% versus 8.1%. The complication rate is 13.3% versus 20.2%. The five-year survival rate of Stage I lung cancer patients is 83.8% versus 73.5%.
Thanks to this innovation, lung cancer VATS that was previously known as a difficult and risky operation has now become more simple and easier to learn. It has therefore gained great popularity across the nation and used in 32 provinces, autonomous regions, and municipalities. This technique has been introduced by over 90% large general hospitals and became a mainstream operation method, leading to higher medical treatment efficiency, significant saving of medical resources, and great benefits to the patients.