Modified Chest Wall Pulley for Lung Excision during Single-Incision Thoracoscopic Surgery for Primary Spontaneous Pneumothorax

Tsuboshima, Kenji; Nagata, Machiko; Wakahara, Teppei; Matoba, Yasumi; Maniwa, Yoshimasa

doi:10.5761/atcs.nm.16-00125

Cited by 5 publications

(6 citation statements)

References 7 publications

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“…13 Furthermore, the utilization of two anchoring sutures that facilitate the small incision U-VATS for the treatment of multiple or comprehensive bullae could be considered. 14…”

Section: Discussionmentioning

confidence: 99%

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Zhang

et al. 2020

J Int Med Res

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Manipulating the instruments during uniportal video-assisted thoracoscopic surgery (U-VATS) bullectomy requires a relatively large incision. This study aimed to investigate the feasibility of next-day discharge following U-VATS bullectomy using an anchoring suture. Methods: A stapler and a scope were inserted through a single incision in the anchoring group. The bullae were retracted by the suture, which was inserted from outside of the chest wall into the thorax, and then bullectomy was performed. For those in the control group, resection of the bullae was performed with the assistance of a grasping forceps. Results: The length of the incision of the patients in the anchoring group ([13.2 AE 2.2] mm) was significantly smaller than in the control group ([26.2 AE 3.9] mm). In addition, the number of staplers used in the anchoring group was significantly less than in the control group ([1.2 AE 0.4] vs. [1.4 AE 0.5]). Furthermore, 36 (92.3%) cases in the anchoring group were uneventfully discharged within 24 hours after bullectomy. Conclusion: Next-day discharge after U-VATS bullectomy through a small incision assisted with an anchoring suture is safe and feasible.

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“…13 Furthermore, the utilization of two anchoring sutures that facilitate the small incision U-VATS for the treatment of multiple or comprehensive bullae could be considered. 14…”

Section: Discussionmentioning

confidence: 99%

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Zhang

et al. 2020

J Int Med Res

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“…Second, the thoracoscope was placed as near to the end of the incision as possible to avoid interference with other instruments. Our technique differs from bullectomy using a stapler under uniportal video-assisted thoracoscopy [7,[13], [14], [15], [16]] in the following regards. 1) Hand ligation of blebs under uniportal video-assisted thoracoscopy may be more convenient.…”

Section: Discussionmentioning

confidence: 99%

“…Because no anchoring suture [7,13,15], retractor [5], or endoloop [14] is required, an ideal angle to facilitate bullectomy is contrived and requires no stapler. However, the required skin incision of 2–3 cm in our technique is larger than that for bullectomy with a stapler [7,[13], [14], [15], [16]]. 2) Manual ligation of blebs under uniportal video-assisted thoracoscopy requires no fleece-coated fibrin glue to reduce the risk of air leaks from the cutting edge.…”

Section: Discussionmentioning

confidence: 99%

Low-cost of uniportal thoracoscopic surgery for primary spontaneous pneumothorax

2019

Respiratory Medicine Case Reports

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Objective Single-incision thoracoscopic surgery is a favorable treatment choice for primary spontaneous pneumothorax, and manual ligation of the bleb during thoracoscopic surgery appears to offer better economic results. In this study we undertook ligation of the bleb by hand under uniportal thoracoscopic surgery for primary spontaneous pneumothorax. Methods Between June 2015 and December 2016, a series of 26 patients with primary spontaneous pneumothorax underwent hand ligation of blebs using the technology of uniportal thoracoscopy, followed by pleural abrasion as necessary. Results No case was converted to two- or three-port video-assisted thoracoscopic surgery during the operation. No patients experienced prolonged (>5 days) air leakage. No other complication was recorded. No recurrence of pneumothorax was encountered during 29–47 months follow-up. Compared with the group treated by bullectomy using stapler, we found a significant reduction in medical costs in the group with bleb ligation. Conclusions Ligation of the bleb by hand under uniportal thoracoscopic surgery for primary spontaneous pneumothorax is a safe and offers better economic results, which is applicable for low income family.

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“…Conventional thoracoscopic surgery is performed via transthoracic approach with surgical incisions from three to two, and then to single one [3–5]. Rencently, The subxiphoid thoracoscopic surgery has been reported as a novel technique, and even it has been used to major lung resections [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Subxiphoid vs transthoracic approach thoracoscopic surgery for spontaneous pneumothorax: a propensity score-matched analysis

et al. 2019

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Background The transthoracic thoracoscopic surgery is currently accepted as a favorable technique for bullectomy for primary spontaneous pneumothorax. Recently, uniportal subxiphoid thoracoscopic surgery has been proposed as an alternative to conventional transthoracic thoracoscopic surgery. Methods From November 2014 and January 2016, 127 consecutive patients who met the inclusion criteria were enrolled in this study. Among these patients, 32 were treated using subxipoid approach, whereas 95 were treated using transthoracic approach. Propensity score case-matching was performed to adjust for patient backgrounds. Results The two groups of 32 pairs were well matched for baseline and surgical characteristics. Patients who underwent subxipoid approach had a longer operation time than transthoracic approach ( p = 0.004). The subgroup analysis showed that the operation time for bilateral bullectomy was similar between the groups ( p = 0.986). There were no differences between the groups with respect to the hospital stay after surgery, chest drain duration, the number of the staples used for the operation, and postoperative recurrence. However, the provoked arrhythmias events during surgery were significantly higher in the subxiphoid approach group ( p = 0.011). Conclusions Although transthoracic thoracoscopic surgery for spontaneous pneumothorax is well established, uniportal subxiphoid thoracoscopic surgery may be a potentially alternative way to management of patients with spontaneous pneumothorax in selected cases, especially for bilateral surgery, but causions should be taked.

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Modified Chest Wall Pulley for Lung Excision during Single-Incision Thoracoscopic Surgery for Primary Spontaneous Pneumothorax

Cited by 5 publications

References 7 publications

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture

Low-cost of uniportal thoracoscopic surgery for primary spontaneous pneumothorax

Subxiphoid vs transthoracic approach thoracoscopic surgery for spontaneous pneumothorax: a propensity score-matched analysis

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