• Title/Summary/Keyword: Thoracoscopic surgery

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PDA Clipping by Using 2mm Thoracoscope (2 mm 흉강경을 이용한 동맥관 개존증 폐쇄술 -1례보고-)

  • Moon, Seung-Chul;Yang, Jin-Young;Koo, Won-Mo;Lee, Gun;Lee, Hyeon-Jae;Lim, Chang-Young
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.85-87
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    • 2000
  • Patent ductus arteriosus(PDA) is a common congenital heart disease encountered in premature neonates infants and children. Patent ductus arteriosus was the first surgically managed congenital heart disease,. Classic surgical interruption of patent ducturs arteriosus was partially replaced by a transcatheter endovascular closure, After a 5-7 mm video-assisted thoracoscopic interruption of the patent ductus arteriosus first applied in 1991, this minimally invasive technique came to be used in many centers, Video-assisted thoracoscopic interruption of the patent ductus arteriosus is feasible in low-weight infants whereas transcatheter endovascular closure of the ductus is usually not possible. We experienced successful outcome for the treatment of patent ductus arteriosus with 2 mm video-assisted thoracoscopic titanium clipping, We believed that this technique is a simple safe and rapid method for closure of the patent arteriosus.

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Thoracoscopic Repair of a Right-sided Congenital Diaphragmatic Hernia -A case report - (흉강경을 이용한 우측 선천성 횡격막 탈장 수술 -1예 보고-)

  • Jo, Tae-Jun;Lee, Jae-Woong;Lee, Weon-Yong;Hong, Ki-Woo;Ahn, Su-Min;Kim, Kun-Il
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.155-158
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    • 2007
  • A congenital diaphragmatic hernia, which mainly occurs in the left thorax, requires an emergency operative procedure during the neonatal periods. A right-sided congenital diaphragmatic hernia is rare, and often detected after the neonatal period due to the mild symptoms. Traditionally, the treatment repairs the diaphragmatic defect via a thoracotomy. However, good results of thoracoscopic repairs have been reported. Herein, the case of a 5-month-old girl, who received a thoracoscopic repair of a right-sided congenital diaphragmatic hernia, is reported.

Thoracoscopic Sympathetic Nerve Reconstruction with using an Intercostal Nerve Graft after Thoracoscopic Sympathetic Clipping for Facial Hyperhidrosis (안면부 다한증에서 흉부교감신경차단수술 후 발생한 보상성 다한증에서 흉강경을 이용한 흉부교감신경 재건술)

  • Haam, Seok-Jin;Lee, Doo-Yun;Kang, Cheong-Hee;Paik, Hyo-Chae
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.807-810
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    • 2008
  • From October 2005 to August 2006, sympathetic nerve reconstruction with using the intercostal nerve was performed in 4 patients with severe compensatory hyperhidrosis following thoracoscopic sympathetic surgery for facial hyperhidrosis. The interval between the initial sympathetic clipping and the sympathetic nerve reconstruction was a median of 23.1 months. The compensatory sweating after sympathetic nerve reconstruction was improved for 2 patients, but it was not improved for 2 patients. Thoracoscopic sympathetic nerve reconstruction may be one of the useful treatment methods for the patients with severe compensatory hyperhidrosis after they under go sympathetic nerve surgery for hyperhidrosis.

Lobectomy with Video-Assisted Thoracoscopy - 4Cases Report - (비디오 흉강경을 이용한 폐엽절제술;4례 보고)

  • 윤용한
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.236-240
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    • 1993
  • Video thoracoscopic surgery is a new modality that gains acceptance rapidly from thoracic surgeons. We have experienced two left lower lobectomies, one left upper lobectomy & one right upper lobectomy with using video thoracoscopy for the four patients with lung parenchymal disease from July 1992 to February 1993. The post-operative courses were uneventful. The final pathologic diagnosis were sclerosing hemangioma, adenocarcinoma, bronchiectasis, leiomyoma & the post-operative courses were short. These patients needed less analgesics because postoperative pain was reduced markedly, and hospitalization was shortened due to rapid recovery. We would like to prefer video thoracoscopic lobectomy to the lobectomy through standard thoracotomy in uncomplicated patients with simple pulmonary parenchymal diseases.

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Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group (경막외마취하에 비디오 흉강경수술 - 고위험군에서)

  • Lee, Song-Am;Kim, Kwang-Taik;Kim, Il-Hyeon;Park, Sung-Min;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.732-738
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    • 1999
  • Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

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Clinical Significance of Thoracoscopy on Spontaneous Pneumothorax (자연기흉에 대한 Thoracoscopy 의 임상적의의)

  • Kim, Young-Toe;Kim, Kun-Ho
    • Journal of Chest Surgery
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    • v.8 no.1
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    • pp.19-28
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    • 1975
  • The thoracoscopic study was reported on 21 cases of spontaneous pneumothorax requiring surgical management, and clinical values of thoracoscopic examination on spontaneous pneumothorax were also discussed. patients were treated in the Department of .Thoracic Surgery, Hanyang University Hospital for the period of two Years from May 1972 to April 1974. For exact detection of etiologic factors on spontaneous pneumothorax, the thoracoscopic examination in the intrapleural space was performed in parallel with X-ray study. this study, the difference of diagnostic and therapeutic significance between radiological and thoracoscopic findings were observed and compared simultaneously. The results are summerized as follows: Patients age was distributed between 3 and 70 years old with highest incidence in the age group of sixty decade [33. 3%], and sex ratio of male to female was 5:2. The tuberculous processes which developed superficial subpleural layer in the lung parenchyme, on the pulmonary surface could be observed by thoracoscopic examination in a characteristic picture. detection ratio of pulmonary tuberculosis by the radiologic study to that by thoracoscopy was 8:2. The adhesion between the visceral and the parietal pleura which could possibly make a rupture of the alveola and the visceral pleura was found to be localized in a small area of the lung surface. The other part of the lung surface was free of the adhesion and, therefore, the movement of the lung took place completely without any difficulty. The ruptured orifice of the pleura and pathological changes surrounding the orifice can be detected by thoracoscopy, but not by other means such as radiologic examination. A single tuberculous bleb and multiple emphysematous blebs were found on 6 cases out of 21 cases of spontaneous pneumothorax. Among these cases, radiologic Study revealed the bleb only in one patient. On the other hand, the blebs were found in all the six patients by means of thoracoscopic examination. It gives the detection ratio of bleb by radiologic study to that by thoracoscopy was 1:6. By thoracoscopy, the rupture on the lung surface were visualized on the 10 patients out of a total of 21 patients [10 patients of visual rupture]. However, the rupture of the pleura was not observed on the rest of 11 patients even by thoracoscopic examination [11 patients of non visual rupture]. Five patients [50%] out of ten who had the visual rupture on the lung surface was required a surgical operation to remove pneumothorax. For the patients who were detected to have the visual rupture of the pleura by thoracoscopy, be considered in the early stage of closed thoracostomy. of 21 patients, 16 patients [11 patients of non visual rupture of the pleura and 5 patients of visual rupture of the pleura] who received no surgical management, were treated with closed thoracostomy with continuous suction, and the` pneumothorax was healed completely up in each cases. Therapeutic measures for the remaining 5 patients of visual rupture of the pleura who were subjected to surgical approach for radical treatment of spontaneous pneumothorax were accordingly complicated, and the following different procedures were properly indicated case by case, that is, rib resection thoracostomy, simple closure of ruptured visceral pleura, wedged resection of the lung, and lobectomy.

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The Effect of Thoracoscopic Sympathicotomy at the Fourth Rib (R4) for the Treatment of Palmar and Axillary Hyperhidrosis

  • Kim, Jae-Bum;Park, Chang-Kwon;Kum, Dong-Yoon
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.154-158
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    • 2011
  • Background: Video-assisted thoracic sympathicotomy plays an important for the treatment of essential hyperhidrosis. Patients are usually satisfied with the surgical outcome at the early post-operative period, but suffer recurrence and compensatory sweating in the late post-operative period. There are many sympathicotomy methods to minimize recurrence and compensatory sweating. We compared the outcome of sympathicotomy methods above the third rib (R3) and the fourth rib (R4) with regards to symptoms, satisfaction, recurrence, and compensatory palmar and axillary hyperhydrosis. Materials and Methods: From January 1999 to April 2009, 39 cases of thoracoscopic sympathicotomy at the third rib (R3), and 94 cases of thoracoscopic sympathicotomy at the fourth rib (R4) for palmar and axillary hyperhidrosis were compared for early and late post-operative satisfaction, compensatory sweating and recurrence. Results: There was no sex or age difference between groups. Early satisfaction was 94.9% and 98.9% in the R3 group and R4 group, respectively. There was no difference in early satisfaction (94.9% in R3 and 98.9% in R4), late satisfaction (84.6% in R3 and 89.4% in R4), or recurrence (17.9% in R3 and 17.0% in R4) between groups. There was significant difference in compensatory sweating (71.8% in R3 and 33% in R4, p=0.002). Conclusion: R4 sympathicotomy demonstrated superior efficacy in the treatment of compensatory sweating compared to R3 in palmar and/or axillary hyperhidrosis.

Bilateral Video-Assisted Thoracoscopic Surgery Resection for Multiple Mediastinal Myelolipoma: Report of a Case

  • Nakagawa, Masatoshi;Kohno, Tadasu;Mun, Mingyon;Yoshiya, Tomoharu
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.189-192
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    • 2014
  • Myelolipoma in the mediastinum is an extremely rare entity. In this report, we present the case of a 79-year-old asymptomatic man who had three bilateral paravertebral mediastinal tumors. The three tumors were resected simultaneously using bilateral three-port video-assisted thoracoscopic surgery (VATS). There has been no evidence of recurrence within four years after the operation. Multiple bilateral mediastinal myelolipomas are extremely rare. There are no reports in the English literature of multiple bilateral thoracic myelolipomas that were resected simultaneously using bilateral VATS. We also present characteristic features of myelolipomas, which are helpful for diagnosis.

Stapling and Suturing of Blebs and Bullae without Excision in Thoracoscopic Surgery (비디오 흉강경하에서 절제없이 봉합에 의한 기포정복술)

  • 김은규;최형호;양현웅;이삼윤;최종범
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.995-998
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    • 1998
  • Background: Prolonged air leak is a common complication after thoracoscopic bullectomy. Materials and methods: A technique is described to minimize postoperative air leak in thoracoscopic surgery for the treatment of recurrent or persistent spontaneous pneumothorax. Results: A 3.5cm utility incision is made in the anterior axillary line at the level of the third intercostal space, and blebs and bullae are stapled and sutured without excision, using standard surgical instruments and stapler. Conclusions: This technique may be useful to reduce prolonged air leak after removal of the bleb and bullous lesion, and may minimize the delayed recurrence of ipsilateral pneumothorax.

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Thoracoscopic Surgery of Upper Esophageal Leiomyoma -One Case Report- (흉강경을 이용한 상부식도 펑활근종의 수술 치험 -1례 보고-)

  • 정진용;심성보
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.585-588
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    • 1996
  • We experienced a case of upper esophageal leiomyoma successfully excised by thoracoscopic surgery. A 29-year-old male was presented with retrosternal discomfort and mild dysphagia and an esophagogram revealed smooth fElling defect In the upper third of the intrathor cic esophagus, and esophagoscopy showed a submucosal tumor without mucosal infiltration. Chest CT and MRI were performed to confirm size, character and location of the esophageal mass, the absence of infiltration of surrounding structures, and to define mediastinal Iymphadenopathy. The tumor was excised by thoracoscopic surgery and it was diagnosed as leiomyoma (4$\times$2xlcm in size). The postoperative course was uneventful.

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