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1 1 Room E 11:30 12:00 12:00 15:10 5, PROGRAM 11: 15 11:30 11:30 12:00 5 Room Room E / 1F 5F ICG Share TEL: FAX: tsato@kuhp.kyoto-u.ac.jp

2 12:00 / 13:50 Special Lecture 12:05-13:00 Chair Hiroshi Date / Kyoto University Tadasu Kohno / Toranomon Hospital 2 14:00-15:00 Challenge & Solution for Difficult Cases / 12:05 12:30 / Sublobar Resection Defining Location, Planes and Margins Ng Sze Hang, Calvin / Associate Professor in Thoracic surgery at Prince of Wales Hospital, The Chinese University of Hong Kong Subxiphoid Uniportal VATS Segmentectomy in Shanghai Pulmonary Hospital Jiang Lei / Associate chief surgeon and associate professor in Thoracic surgery department, Shanghai pulmonary hospital / 06 14: :10 / / / / / / / 1 13:00-13:50 Various Approaches for Sublobar Resection / 08 14:20 / / / / / / 2 / 01 13: :10 13:20 Virtual-assisted lung mapping (VAL-MAP) Uniportal VATS / / / / / / / / ICG / / / / / / / 09 14: : :50 / / / / / / / / / / / / / ENB guided dye marking for the surgery of small subsolid nodules In Kyu Park Professor, Department of Thoracic and Cardiovascular surgery, Seoul National University Hospital, Seoul National University College of Medicine Novel surgical stapler designed for sublobar resection Min-Woong Kang. MD, PhD. Associate Professor, Department of Thoracic and Cardiovascular surgery, School of Medicine, Chungnam National University, Daejeon, South Korea :30 3-port VATS / / / / / / / 15:00 / 05 13:40 Methodologies for Sub-lobar Resection in Kyoto University Hospitals / / / / / / / / 15:05 / Korea In Kyu Park Seoul National University Min-Woong, Kang Chungnam National University Jiang Lei Shanghai Pulmonary Hospital Calvin Ng Hong Kong Prince Wales Hospital Shanghai Pulmonary Hospital 1 Ng England Hong Kong The 17th JAVATS 02

3 Special Lecture Chair Hiroshi Date / Kyoto University Tadasu Kohno / Toranomon Hospital 13:00-13:50 Various Approaches for Sublobar Resection / Sublobar Resection Defining Location, Planes and Margins Ng Sze Hang, Calvin Associate Professor in Thoracic surgery at Prince of Wales Hospital, The Chinese University of Hong Kong Sublobar resection, in particular anatomical segmentectomy, is increasingly becoming more complex as the requirement to accurately localize the small lung lesion(s), define segmental resection planes and intraoperatively ensure adequate margins are becoming the cornerstones of performing high precision surgery. Sophisticated marking techniques using different markers such as metallic elements, radiopaque contrast medium, methylene blue and indocyanine green amongst others have been reported. Furthermore, anatomical boundaries, segmental bronchus inflation-deflation methods, and segmental perfusion method to define intersegmental plane for resection provide their own advantages and disadvantages, which may even be associated with specific complications. Various approaches in an attempt to intraoperatively confirm adequate margins during sublobar resection may not provide solution for every situation. The lecture will focus on some of these challenges and look at how technology may provide solutions to these problems. 01 Virtual-assisted lung mapping (VAL-MAP) Uniportal VATS / / / / / / / / Uniportal VATS VAL-MAP S6c+8+9 S1, S6, S8a+9 S8+9 S10 VAL-MAP uniportal VATS pitfall 02 ICG / / / COPD 2017 ICG Subxiphoid Uniportal VATS Segmentectomy in Shanghai Pulmonary Hospital Jiang Lei Associate chief surgeon and associate professor in Thoracic surgery department, Shanghai pulmonary hospital Backgrounds Subxiphoid single port, named SVATS, become a new approach for VATS lung resections, and may completely eradicate chronic postoperative incisional pain. Objectives The aim is to introduce our experiences of SVATS segmentectomy, especially concerning the indications, surgical procedures, and complications. Methods and Results From Sep 2014 to Apr 2017, 242 consecutive patients underwent SVATS segmentectomy, in which 29 patients received two procedures, including segment, lobe, and mediastinal mass resections. The total conversion rate was 5.53%, only 1.47% segmentectomies conversed to open porcedures, while twice patients conversed to two-port VATS, the rate was 2.95%. In addition, three patients changed to lobectomy because of injuries to bronchus and/or vessels. The complication rate was 8.26%, while major complication was rate 1.65%, others were minor complications. Furthermore, No patients suffered from bronchopleural fistula, incisional hernia, and operative death. Conclusions Subxiphoid uniportal incision is a feasible approach for pulmonary segmentectomy, from S1-S10 on both sides in Shanghai Pulmonary Hospital. SVATS segmentectomy would still be a technically demanding procedure, and have to depend on meticulous cooperation between surgeons and anesthetists and nurses. 03 / / / / device port VATS / / / / / / / CT ICG 1/3 surgical margin CT 05 Methodologies for Sub-lobar Resection in Kyoto University Hospitals / / / / / / / / Sub-lobar Resection VAL MAP ICG The 17th JAVATS 04

4 2 14:00-15:00 Challenge & Solution for Difficult Cases / 06 / / / / / Non-invasive CT marking (NICTM) 07 / / 3D volume rendering segmentation 10mm 20mm Novel surgical stapler designed for sublobar resection 11 Min-Woong Kang. MD, PhD. Associate Professor, Department of Thoracic and Cardiovascular surgery, School of Medicine, Chungnam National University, Daejeon, South Korea. Recently, sublobar resection has emerged as a surgical treatment for early lung cancer. Currently, a randomize control trial such as JCOG0804 or JCOG0802 is underway and the feasibility for sublobar resection is likely to be established soon. The biggest problem in sublobar resection is local recurrence. To prevent local recurrence, we need to obtain R0 resecetion, so R0 resection is the most important thing in sublobar resection. Sublobar resection using conventional stapler has a fatal disadvantage that frozen section biopsy cannot be done in true resection margin. In this study, a new stapler which can obtain true resection margin was studied. We conducted a large animal experiment using a novel surgical stapler. Experimental results showed that, in case of lung resection using a novel stapler, a true resection margin was obtained with a fresh resection margin without squeezing artifact in the tissue, unlike in the conventional stapler. In conclusion, this novel stapler could be useful for the pathologic evaluation of the true surgical margin. 08 / / / / / / / / / / / / / / / / / / / STAS spread through air spaces STAS STAS staple 10 ENB guided dye marking for the surgery of small subsolid nodules In Kyu Park Professor, Department of Thoracic and Cardiovascular surgery, Seoul National University Hospital, Seoul National University College of Medicine Various localization methods are used for intraoperative localization of small subsolid nodules. Electromagnetic navigation bronchoscopy (ENB) is an effective system for the localization pulmonary lesions. One of advantage of ENB is that it can be done by surgeons themselves intraoperatively after induction of anesthesia. Patients don t need to experience additional pain and fear which come with procedures performed under local anesthesia. The work-flow of hospital become more efficient because transportation of patient is not necessary. Localization can be done with dye, fluorescent materials, or radiopaque materials. Dye-marking is the cheapest and simplest method because no specific detecting device is not necessary. SNUH apply ENB-guided dye marking not only for localization of small subsolid nodules but also for marking of resection margin or segmental plane. Details about ENB-guided dye marking and latest results of SNUH experiences will be presented. USB Macintosh PC Microsoft Power Point 2007 Windows 10 Windows 10 Windows Media Player 11 WMV PC Macintosh PC Mini D-sub 15 PC AC PC The 17th JAVATS 06

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