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Article Citation - WoS: 1Citation - Scopus: 1Current New Approach in Thoracoscopic Surgery: Non-Intubated Uniportal Video-Assisted Thoracoscopic Surgery (Ni-Univats)(Mdpi, 2025) Agar, Mehmet; Gulcek, Ilham; Kalkan, Muhammed; Ulutas, Hakki; Celik, Muhammet Reha; Aksu, Ahmet; Cakmak, MuharremBackground and Objectives: Non-intubated uniportal video-assisted thoracoscopic surgery (NI-UniVATS) is a minimally invasive technique performed using a single port, allowing the entire surgical procedure to be completed with spontaneous breathing without the need for general anesthesia. Materials and Methods: This retrospective study included 51 patients who underwent NI-UniVATS between 2020 and 2023. The intraoperative and postoperative data of patients who underwent NI-UniVATS were evaluated. Results: Among the cases, 37 (72.5%) were male, and 14 (46.6%) were female, with a mean age of 47.73 +/- 20.43 years (range: 18-78 years). The mean operative time was 25.92 +/- 7.31 min. No perioperative complications were observed in any patient. The mean postoperative hospital stay was 4.17 +/- 1.76 days (range: 2-9 days). A right hemithoracic approach was performed in 28 patients (54.9%), whereas a left hemithoracic approach was used in 23 patients (45.1%). The procedures performed included wedge resection in 27 patients (52.9%), biopsy in 22 patients (43.1%), pericardial window creation in one patient (2%), and intrathoracic foreign body removal in one patient (2%). Conclusions: NI-UniVATS allows for safer surgery by preventing the adverse effects and complications associated with general anesthesia. NI-UniVATS can be recommended as a safe and feasible approach for both minor and major thoracic procedures.Article Semiautomated Delay Analysis Method Selection for Construction Projects: A Rule-Based Approach(ASCE-Amer Soc Civil Engineers, 2026) Agar, Mehmet; Sonmez, Rifat; Aminbakhsh, SamanGiven the availability of various delay analysis methods, each yielding different results, the proper selection of an appropriate methodology is of paramount importance. Despite the necessity for automation to resolve delay conflicts, the current literature lacks an automated approach to assist contractors and project owners in reaching a consensus on selecting the most suitable delay analysis method without requiring a third party. Hence, to bridge the gap between theoretical research and practical application in achieving an automated delay analysis method, a novel rule-based expert system has been proposed. A structured, multiphase methodology that includes a review of existing methods, identification of key facts, determination of facts and expert rules, development of a forward chaining inference engine, and validation stages is used. Five real-world case examples and the decisions of experts for 15 hypothetical case examples are used for validation. The case examples demonstrate that the system can successfully automate the selection of the most appropriate delay analysis method and support a transparent, systematic approach to managing delays in construction projects. Furthermore, the system can foster consensus among project stakeholders during the selection of a delay analysis method and has the potential to contribute to the resolution of delay disputes.Article Citation - WoS: 1Citation - Scopus: 1Utilising Uniportal Video-Assisted Thoracoscopic Surgery for Pericardial Window: A 12-Year Single-Centre Experience in the Diagnosis and Treatment of Pericardial Effusion(Wolters Kluwer Medknow Publications, 2025) Agar, Mehmet; Gulcek, Ilham; Kalkan, Muhammed; Ulutas, Hakki; Celik, Muhammet RehaIntroduction:Uniportal video-assisted thoracoscopic surgery (Uni-VATS) is an effective minimally invasive technique for pericardial drainage, biopsy and window creation in cases of pericardial effusion (PE).Patients and Methods:This retrospective study evaluated 73 patients with PE who underwent pericardial window procedures between 2012 and 2024. Intraoperative and post-operative data related to Uni-VATS were assessed.Results:The mean age of the patients was 53.79 +/- 17.79 years (10-82 years), with 34 (46.6%) females and 39 (53.4%) males. The mean volume of pericardial fluid drained after window creation was 446.23 +/- 199.81 cc (75-1100 cc). The mean operation time was 42.87 +/- 12.79 min, and chest drain removal occurred after an average of 1.8 +/- 1.2 days. The mean duration until discharge or referral to the follow-up clinic was 5.98 +/- 2.14 days. In addition to the pericardial window procedure, pleural biopsy was performed in 12 patients, mediastinal mass biopsy in eight patients and wedge resection for parenchymal nodules in six patients. Microbiologic and virologic cultures of the fluids were negative in all cases. Among the 41 patients with benign cytology, pericardial biopsy results indicated tuberculosis in four patients (5.4%), amyloidosis in one patient (1.3%) and chronic or subacute nonspecific pericarditis in the remaining patients.Conclusion:Uni-VATS is a novel and safe technique that may be the preferred choice for pericardial window due to its diagnostic and therapeutic efficacy, ability to perform simultaneous procedures, favourable impact on operation duration/hospital stay, low complication rates and superiority compared to traditional methods.
