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Article ; Online: Robotic Camera Assistance: The Future of Laparoscopic and Thoracoscopic Surgery?

Ali, Jason M / Lam, Kyle / Coonar, Aman S

2018 Volume 25, Issue 5, Page(s) 485–491

Abstract: Introduction: Minimally invasive techniques have become the standard for a variety of procedures across all surgical specialties. There has been a recent move to integrate robotic technology into standard laparoscopic and thoracoscopic surgery with the ... ...

Abstract	Introduction: Minimally invasive techniques have become the standard for a variety of procedures across all surgical specialties. There has been a recent move to integrate robotic technology into standard laparoscopic and thoracoscopic surgery with the aim of improving stability of the visual field with the use of robotic camera assistance. The aim of this study was to report on and examine the use of a headset-controlled robotic camera holder, FreeHand. Methods: Between May 2013 and Dec 2016, 105 procedures were observed where the FreeHand robotic camera assistant was used. Observations were made of 43 consultant surgeons in 30 hospitals performing 21 different surgical procedures. During the surgery, the number of scope cleans and collisions were quantified, and surgeons were asked to score from 0 to 5 the setup, ergonomics, usability, and overall experience in a questionnaire. Results: Overall surgeon satisfaction was rated as "good" for setup (4.29), ergonomics of the system (4.12), usability (4.39), and overall experience of the system (4.34). In 8 operations (7.6%), there was a conversion from robotic camera assistant to manual assistant. There were no reported adverse events attributable to the use of the system. Conclusion: This study demonstrates the breadth of surgical procedures that can be performed with a robotic camera assistant. The robotic camera assistant was found to be safe and simple to use and was positively perceived on assessment in multiple procedures spanning several surgical specialties. This work suggests that robotic camera assistants may offer significant benefits to laparoscopic and thoracoscopic surgeons.
MeSH term(s)	Equipment Design ; Humans ; Laparoscopy/instrumentation ; Laparoscopy/methods ; Robotic Surgical Procedures/instrumentation ; Robotic Surgical Procedures/methods ; Thoracoscopy/instrumentation ; Thoracoscopy/methods
Language	English
Publishing date	2018-06-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/1553350618784224
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Article ; Online: Multicentre evaluation of renal impairment in thoracic surgery (MERITS): a retrospective cohort study.

Naruka, Vinci / McKie, Mikel Alexander / Ahmadi, Navid / Pama, E A Claudia / Coonar, Aman S / Collaborators, Merits

BMJ open

2022 Volume 12, Issue 9, Page(s) e058542

Abstract: Objectives: To measure the unit-level variation in Acute Kidney Injury (AKI) incidence post-thoracic surgery over a contemporary 1-year period. Secondary aims include examining the associations with sex, age group, operation type, length of stay and ... ...

Abstract	Objectives: To measure the unit-level variation in Acute Kidney Injury (AKI) incidence post-thoracic surgery over a contemporary 1-year period. Secondary aims include examining the associations with sex, age group, operation type, length of stay and mortality. Design: A multicentre, observational, retrospective study in thoracic surgery. Setting: 17 of 35 Society for Cardiothoracic Surgery of Great Britain and Ireland (SCTS) units participated. The student wing, known as SCTS STUDENTS, supported data collection. Participants: Overall, 15 229 patients were collected of which 15 154 were included for analysis after exclusions. All patients (age≥18 years) undergoing any thoracic surgery from 1 April 2016 to 31 March 2017 were included. For analysis, we excluded patients with preoperative end-stage renal failure and those with incomplete data. Main outcome measures: The primary outcome is the incidence of AKI within 7 days of the procedure or discharge date if earlier. Secondary outcomes include assessing associations with patient demographics (age, sex), type of procedure (open and minimally invasive), length of stay and mortality. Results: Out of 15 154 patients AKI was diagnosed in 1090 patients (7.2%) within 7 days of surgery with AKI stage 1 (4.8%), stage 2 (1.7%) and stage 3 (0.7%). There was a statistically significant variation in AKI incidence between units from 3.1 to 16.1% (p<0.05). Significant differences between AKI and non-AKI were found in post-operative length of stay (7 vs 3 days, p<0.001), 30-day mortality (9 vs 1.6%, p<0.001), 90-day mortality (14.7 vs 4.4%, p<0.001) and 1-year mortality (23.1 vs 12.2 %, p<0.001). Conclusions: Following thoracic surgery, AKI incidence ranged from 3.1% to 16.1% between units (p<0.05) with associations between AKI and both length of stay and mortality. We propose AKI as a suitable comparative and absolute quality measure in thoracic surgery. Reducing rates of AKI may improve patient outcomes, length of stay and reduce costs.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Adolescent ; Humans ; Incidence ; Retrospective Studies ; Risk Factors ; Thoracic Surgery ; Thoracic Surgical Procedures/adverse effects
Language	English
Publishing date	2022-09-27
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-058542
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Article ; Online: Surgical Management of Thoracic Multiple Exostoses.

Kanthasamy, Senthooran / Aresu, Giuseppe / Peryt, Adam / Coonar, Aman S

The Annals of thoracic surgery

2019 Volume 109, Issue 5, Page(s) e361–e362

Abstract: Hereditary multiple exostoses is a rare autosomal dominant condition resulting in the development of multiple osteochondromas. We present the case of a 25-year-old woman with hereditary multiple exostoses who was referred for thoracic surgery assessment ... ...

Abstract	Hereditary multiple exostoses is a rare autosomal dominant condition resulting in the development of multiple osteochondromas. We present the case of a 25-year-old woman with hereditary multiple exostoses who was referred for thoracic surgery assessment due to severe right-sided chest pain. Computed tomographic scan allowed preoperative planning for resection of the lesion. Under general anesthesia, right video-assisted thoracoscopic surgery was performed through a cosmetic retromammary incision. Complete removal of the tumor resolved symptoms, and she was discharged 2 days later. We show that video-assisted thoracoscopic surgery with a cosmetically placed muscle-sparing incision allowed accurate resection with faster recovery.
MeSH term(s)	Adult ; Bone Neoplasms/diagnosis ; Bone Neoplasms/genetics ; Bone Neoplasms/surgery ; Chest Pain/etiology ; Chromosome Aberrations ; Exostoses, Multiple Hereditary/diagnosis ; Exostoses, Multiple Hereditary/genetics ; Exostoses, Multiple Hereditary/surgery ; Female ; Genes, Dominant ; Humans ; Minimally Invasive Surgical Procedures ; Precancerous Conditions/diagnosis ; Precancerous Conditions/genetics ; Precancerous Conditions/surgery ; Thoracic Neoplasms/diagnosis ; Thoracic Neoplasms/genetics ; Thoracic Neoplasms/surgery ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed
Language	English
Publishing date	2019-10-04
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2019.08.088
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Article ; Online: High-risk surgery: the courage to fail.

Pepper, John R / Coonar, Aman S

Journal of the Royal Society of Medicine

2014 Volume 108, Issue 2, Page(s) 44–46

MeSH term(s)	Databases as Topic ; Heart Diseases/surgery ; Humans ; Patient Selection ; Practice Guidelines as Topic ; Prognosis ; Quality Assurance, Health Care ; Risk Assessment ; Thoracic Surgery/standards ; Thoracic Surgery/trends ; Thoracic Surgical Procedures/psychology ; Thoracic Surgical Procedures/standards ; Thoracic Surgical Procedures/trends ; Treatment Failure
Language	English
Publishing date	2014-12-17
Publishing country	England
Document type	Editorial
ZDB-ID	6731-3
ISSN	1758-1095 ; 0141-0768 ; 0035-9157
ISSN (online)	1758-1095
ISSN	0141-0768 ; 0035-9157
DOI	10.1177/0141076815571515
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Article ; Online: Subxiphoid uniportal video-assisted thoracoscopic lung volume reduction surgery.

Nashaat, Abraham / Aresu, Giuseppe / Peryt, Adam / Coonar, Aman S

Interactive cardiovascular and thoracic surgery

2018 Volume 28, Issue 3, Page(s) 485–486

Abstract: We present the case of a 50-year-old woman with severe emphysema, who underwent subxiphoid uniportal video-assisted lung volume reduction surgery. Standard techniques include staged unilateral video-assisted thoracoscopic surgery and historically ... ...

Abstract	We present the case of a 50-year-old woman with severe emphysema, who underwent subxiphoid uniportal video-assisted lung volume reduction surgery. Standard techniques include staged unilateral video-assisted thoracoscopic surgery and historically sternotomy and thoracotomy. Concerns that the subxiphoid incision may have impacted on the abdominal component of ventilation was considered; however, this was not the case, and pain control was excellent. The patient was discharged home after 3 days with no chest drain. Lung function and performance status have improved considerably.
MeSH term(s)	Female ; Humans ; Lung/surgery ; Middle Aged ; Pneumonectomy/methods ; Pulmonary Emphysema/surgery ; Thoracic Surgery, Video-Assisted/methods ; Xiphoid Bone
Language	English
Publishing date	2018-08-23
Publishing country	England
Document type	Case Reports ; Journal Article ; Video-Audio Media
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivy239
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Zs.A 5730: Show issues

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Article: Hybrid video-assisted thoracoscopic surgery lobectomy and en-bloc chest wall resection for non-small cell lung cancer.

Caruana, Edward J / Solli, Pierogiorgio / Coonar, Aman S

Journal of thoracic disease

2016 Volume 8, Issue 9, Page(s) E935–E937

Abstract: Chest wall invasion is seen in 5% to 8% of patients presenting with lung cancer. We report a case of complete resection of a 14 cm × 9 cm pT3N0M0 squamous cell carcinoma arising from the right lower lobe and invading the lower chest wall posteriorly, in ... ...

Abstract	Chest wall invasion is seen in 5% to 8% of patients presenting with lung cancer. We report a case of complete resection of a 14 cm × 9 cm pT3N0M0 squamous cell carcinoma arising from the right lower lobe and invading the lower chest wall posteriorly, in a 75 years old male, via a hybrid thoracoscopic [video-assisted thoracoscopic surgery (VATS)] approach. Following conventional VATS lobectomy, a targeted 10 cm incision was performed to allow wide resection of the 7
Language	English
Publishing date	2016-07-04
Publishing country	China
Document type	Case Reports
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2016.08.24
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Article ; Online: Single-cell transcriptomic analysis of human pleura reveals stromal heterogeneity and informs

Obacz, Joanna / Valer, Jose Antonio / Nibhani, Reshma / Adams, Taylor S / Schupp, Jonas C / Veale, Niki / Lewis-Wade, Amanah / Flint, Jasper / Hogan, John / Aresu, Giuseppe / Coonar, Aman S / Peryt, Adam / Biffi, Giulia / Kaminski, Naftali / Francies, Hayley / Rassl, Doris M / Garnett, Mathew J / Rintoul, Robert C / Marciniak, Stefan J

The European respiratory journal

2024 Volume 63, Issue 1

Abstract: The pleural lining of the thorax regulates local immunity, inflammation and repair. A variety of conditions, both benign and malignant, including pleural mesothelioma, can affect this tissue. A lack of knowledge concerning the mesothelial and stromal ... ...

Abstract	The pleural lining of the thorax regulates local immunity, inflammation and repair. A variety of conditions, both benign and malignant, including pleural mesothelioma, can affect this tissue. A lack of knowledge concerning the mesothelial and stromal cells comprising the pleura has hampered the development of targeted therapies. Here, we present the first comprehensive single-cell transcriptomic atlas of the human parietal pleura and demonstrate its utility in elucidating pleural biology. We confirm the presence of known universal fibroblasts and describe novel, potentially pleural-specific, fibroblast subtypes. We also present transcriptomic characterisation of multiple
MeSH term(s)	Humans ; Pleura/pathology ; Mesothelioma/genetics ; Mesothelioma/pathology ; Mesothelioma, Malignant/pathology ; Pleural Neoplasms/genetics ; Pleural Neoplasms/pathology ; Gene Expression Profiling
Language	English
Publishing date	2024-01-25
Publishing country	England
Document type	Journal Article
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/13993003.00143-2023
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Article ; Online: No time to train the surgeons: the rot is deep.

Coonar, Aman S

BMJ (Clinical research ed.)

2004 Volume 328, Issue 7448, Page(s) 1134; discussion 1134–5

MeSH term(s)	Education, Medical, Graduate/organization & administration ; General Surgery/education ; General Surgery/standards ; United Kingdom
Language	English
Publishing date	2004-05-08
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.328.7448.1134
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Article ; Online: Opioid-Free Anesthesia for Lung Cancer Resection: A Case-Control Study.

Devine, Gary / Cheng, Maureen / Martinez, Guillermo / Patvardhan, Chinmay / Aresu, Giuseppe / Peryt, Adam / Coonar, Aman S / Roscoe, Andrew

Journal of cardiothoracic and vascular anesthesia

2020 Volume 34, Issue 11, Page(s) 3036–3040

Abstract: Objective: To assess the feasibility and effectiveness of an opioid-free anesthesia (OFA) technique in lung cancer resection surgery versus standard opioid-based techniques.: Design: Retrospective, propensity-matched, case-control study.: Setting: ...

Abstract	Objective: To assess the feasibility and effectiveness of an opioid-free anesthesia (OFA) technique in lung cancer resection surgery versus standard opioid-based techniques. Design: Retrospective, propensity-matched, case-control study. Setting: A single, specialty cardiothoracic center between January 2018 and July 2019. Participants: Adult patients undergoing lung cancer resection surgery. Interventions: A cohort of 83 patients undergoing an OFA technique (OFA group) for lung cancer resection surgery was matched with 83 patients who underwent similar surgery with a standard anesthesia technique (STD group). Outcome measures compared between the 2 groups included postoperative pain scores at 0, 1, and 24 hours; 24-hour postoperative morphine patient-controlled analgesia consumption; recovery room and hospital lengths of stay; and 30-day all-cause mortality. Measurement and main results: No difference was found in median pain scores (interquartile range [IQR]) at 0 hours: STD 0 (0-1), OFA 0 (0-1); p = 0.48. Median pain scores (IQR) at 1 hour were statistically significantly greater in the STD group compared with the OFA group: STD 1 (0-1), OFA 0 (0-1); p = 0.03. There was no difference in median pain scores (IQR) at 24 hours: STD 0 (0-1), OFA 0 (0-1); p = 0.49. Mean postoperative 24-hour patient-controlled analgesia morphine consumption (standard deviation) was similar between groups: STD 21.1 (±18.8) mg, OFA 16.2 (±18.1) mg; p = 0.16. There was no difference in mean time spent in the postoperative recovery (standard deviation) area between the 2 groups: STD 116 (±49) minutes, OFA 108 (±34) minutes; p = 0.27. Median hospital length of stay (IQR) was longer in the STD group compared with the OFA group: STD 4 (2-6) days, OFA 3 (2-4) days; p = 0.002. Conclusions: This case-control study demonstrated that an OFA technique in lung cancer resection surgery offers a feasible and safe approach, resulting in similar postoperative pain scores and morphine consumption compared with standard opioid-containing techniques.
MeSH term(s)	Adult ; Analgesics, Opioid ; Anesthesia ; Case-Control Studies ; Humans ; Lung Neoplasms/surgery ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control ; Retrospective Studies
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2020-05-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2020.05.022
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Article: The role of positron emission tomography in the diagnosis, staging and response assessment of non-small cell lung cancer.

Volpi, Sara / Ali, Jason M / Tasker, Angela / Peryt, Adam / Aresu, Giuseppe / Coonar, Aman S

Annals of translational medicine

2018 Volume 6, Issue 5, Page(s) 95

Abstract: Lung cancer is a common disease and the leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for the majority of cases. Following diagnosis of lung cancer, accurate staging is essential to guide clinical ... ...

Abstract	Lung cancer is a common disease and the leading cause of cancer-related mortality, with non-small cell lung cancer (NSCLC) accounting for the majority of cases. Following diagnosis of lung cancer, accurate staging is essential to guide clinical management and inform prognosis. Positron emission tomography (PET) in conjunction with computed tomography (CT)-as PET-CT has developed as an important tool in the multi-disciplinary management of lung cancer. This article will review the current evidence for the role of
Language	English
Publishing date	2018-04-03
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2893931-1
ISSN	2305-5847 ; 2305-5839
ISSN (online)	2305-5847
ISSN	2305-5839
DOI	10.21037/atm.2018.01.25
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