Thorax Surgery

**99**

**Chapter 8**

**Abstract**

*and Edris Mahtab*

reality, endo-bronchial surgery

tant step in the history of surgery.

the chest" in 1879) [4].

**1. Introduction**

The Realm of Oncological Lung

*Alexander Maat, Amir Hossein Sadeghi, Ad Bogers* 

general introduction to several aspects of oncological lung surgery.

**Keywords:** lung cancer, lung surgery, VATS, UVATS, RATS, thoracotomy, virtual

For centuries, the inside of the chest cavity was a no-go area for complex surgical interventions. The problems of an open pneumothorax were already known by the ancient Greek Celsus around the year 30 AD noted: "as soon as the knife really penetrates to the chest, by cutting through the transverse septum, a sort of membrane which divides the upper from the lower parts, the man loses his life at once" [1]. At that time, drainage of an empyema as described by Hippocrates (approx. 460–375 BC) was the only feasible operation [2]. The first report of a successful lung resection is attributed to Roland of Parma in 1499 who resected the herniating part of a lung, days after a penetrating chest trauma [3]. In 1846, general anesthesia with ether had been introduced by William Morton in Boston, an extremely impor-

During the mid-nineteenth century, when tuberculosis reached its highest incidence, it was recognized that a state of rigidity of the mediastinum permitted an open pneumothorax. Estlander of Helsingfors was one of the first to describe wide thoracoplasty in order to "rest" a lung affected by tuberculosis ("decostalisation of

Future Perspectives

Surgery: From Past to Present and

In this chapter, a historical overview as well as an overview of state of the art of the surgical techniques for the treatment of lung cancer is outlined. The chapter focuses on the introduction of open surgery, video-assisted thoracic surgery (VATS), uniportal VATS (UVATS), and robotic-assisted thoracic surgery (RATS) techniques for lung resections. A short introduction on upcoming techniques and modalities is given. The currently available tools as three-dimensional (3D) computed tomography (CT), virtual reality, and endo-bronchial surgery will be discussed. Based on the current development, this chapter attempts to delineate the horizon of oncological lung surgery. The information is generated not only from the available literature, but also from the experiences of surgeons and other physicians as well as co-workers involved in lung cancer treatment around the world. This chapter can be seen as a

## **Chapter 8**
