Interview with Prof. Roberto Crisci: Personal opinions on current minimally invasive techniques in thoracic surgery

Posted On 2022-10-12 15:51:25

Roberto Crisci1, Kenney Hong2, Lucine M. Gao2

1Thoracic Surgery Unit, University of L’Aquila, “G. Mazzini” Hospital, Teramo, Italy; 2VATS Editorial Office, AME Publishing Company.

Correspondence to: Kenney Hong. VATS Editorial Office, AME Publishing Company. Email: vats@amegroups.com.


Editor’s Note

Video-Assisted Thoracic Surgery (VATS) aims to promote the development of video-assisted thoracic surgery around the world by providing a professional platform for the sharing of experience in video-assisted thoracic surgery between peers so that all patients may benefit. It has published a number of special series reporting the cutting-edge findings and application of video-assisted thoracic surgery in recent years, and received overwhelming responses from academic readers around the world. Our success cannot be achieved without the contribution of our distinguished guest editors. Taking this opportunity, VATS launched a new series “Interviews with Outstanding Guest Editors” this year to highlight our active contributors. We hope to express our heartfelt gratitude for their tremendous effort and to further uncover the stories behind the special series.

The special series “Non-Intubated Thoracic Surgery. A Global Perspective”(1) and “VATS Special Issue dedicated to the 4th international VATS Symposium 2017”(2) led by Prof. Roberto Crisci (Figure 1) from University of L’Aquila, “G. Mazzini” Hospital has attracted numerous readers since they were published. These series had the intent to focus on two current and important topics in Thoracic Surgery. Hereby, we are honored to have an interview with Prof. Crisci to share his experience in thoracic surgery and his insights on this special series.

Expert Introduction: 

Full Professor of Thoracic Surgery at the University of L’Aquila. director of the School of Specialization in Thoracic Surgery. director of the thoracic surgery unit of the Teramo hospital. Former President of the Italian Society of Thoracic Endoscopy (SIET) and current President of the Italian Society of Thoracic Surgery (SICT). Founder and Honorary President of the Italian VATS Group. Founder and Scientific Director of the Lucent group. Expert in Oncological and Traumatological Surgery of the Chest.

Figure 1 Prof. Roberto Crisci

VATS: What made you decide to be a doctor and what originally led you to the study of thoracic surgery?

Prof. Crisci: Towards medicine, the heroic vision of the doctor pushed me, but it was a romantic vision by now obsolete. Towards thoracic surgery, since I was a student, my interest in lung and rib cage physiopathology pushed me.

VATS: The “VATS” special series published in 2017 covers the principles of enhanced recovery, technical VATS and robotic aspects with debate about the advantages of the robot over vats. Many years have passed this special series was published, could you briefly introduce the evolution of VATS in lung cancer treatment in recent years?

Prof. Crisci: I have always been a great supporter of VATS (just think of the Italian VATS Group, which I created and founded in 2013) and I remain so. VATS is now also usable for segmentectomies and wall demolitions, in a hybrid technique. It also maintains an economic convenience that is fundamental today.

VATS: Regarding the debate about the advantages of the robot over vats, what do you think about it? What are the advantages and disadvantages of robotics and VATS?

Prof. Crisci: In my opinion, the two techniques are equivalent in terms of technical potential and oncological results. The post-operative courses are also equivalent. As I said, the economic advantage remains for the VATS. I do not exclude that the robot of new generations may subvert this current belief of mine in future years.

VATS: In recent years, a variety of new systems appear for the treatment of lung cancer, such as the RATS system and the glass-free 3D VATS system. Which do you think will be the mainstream for future thoracic surgery and what about the future development of these systems?

Prof. Crisci: As far as I am concerned, the recent innovations mentioned have not decisively influenced the balance between the two methods. Predicting the technological future is practically impossible, even if we surgeons have high expectations.

VATS: In the “Non-Intubated Thoracic Surgery. A Global Perspective”(1) special series, you have left a question - “Is the non-intubated thoracic surgery the most excellent care or an unnecessary surgical challenge?” Could you please share your opinion on this?

Prof. Crisci: As always, the answer comes from the surgeon’s decision-making balance. This type of surgery cannot and should not represent standard, however, there are pathophysiological conditions that can take advantage of this method.

VATS: What kind of projects are you recently working on? How is the topic of these special series associated with some of them?

Prof. Crisci: Currently I have created a new study group, with registry, to study the results of surgery associated with complementary therapies, in particular immunotherapy and target therapy. This topic could still be a focus for a new special series.

VATS: If there is a chance to update these special series, what content do you want to moderate, and or emphasize more?

Prof. Crisci: I believe that the one on VATS and Robotics could be updated in a couple of years after the planned marketing of new devices.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Video-Assisted Thoracic Surgery for the series “Interviews with Outstanding Guest Editors”. The article did not undergo external peer review.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form. The series “Interviews with Outstanding Guest Editors” was commissioned by the editorial office without any funding or sponsorship. KH and LMG report that they are full-time employees of AME Publishing Company. The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

  1. Non-Intubated Thoracic Surgery. A Global Perspective. Available online: https://vats.amegroups.com/post/view/non-intubated-thoracic-surgery-a-global-perspective
  2. VATS Special Issue dedicated to the 4th international VATS Symposium 2017. Available online: https://vats.amegroups.com/post/view/vats-special-issue-dedicated-to-the-4th-international-vats-symposium-2017