呼吸器外科における最先端手術手技とCAL（Clinical Anatomy Laboratory）

Recently, endoscopic surgery is the most common procedurein the field of thoracic surgery. The newestthoracic surgeryapproaches are the video-assisted thoracic surgery（VATS）, the one-port video-assisted thoracic surgery, and the robotic surgery. The individual advantages and disadvantages of these procedures have been discussed. VATS covers a field of view of the surgical field from the leg to the head. The basic method in performing VATS is that the surgeon operates on the abdominal area of the patient and the assistant expands the surgical field from the patient’s back. It is currently the standard surgical procedure. The advantage of one-port VATS is the one port itself and its cosmetic advantages and pain reduction. The advantage of robotic surgery is that it has a clear three-dimensional enlarged field of view and can be performed using the delicate moving robotic arm. However, a good surgical training system should be established for the familiarization of these procedures. The clinical anatomy laboratory is the most efficient surgical training in addition to dry and wet lab training. Our institution has fresh-frozen cadavers, which are rare in Japan. The participating thoracic surgeons underwent training for VATS lobectomy, subxiphoid extended thymectomy, and pleurectomy decortication.
This training is beneficial for educational and clinical purposes. In the future, we must obtain consistent surgical education before and after graduation using fresh-frozen cadavers. At the same time, a good organ model for training is also necessary. The surgeon has to cooperate with anatomy doctors for the development of a good surgical organ model. For the development of future surgical medicine, surgical training programs should be implemented.