Surgical Thoracoscopy

ISBN-13: 9782817809090 / Angielski / Miękka / 2012 / 114 str.

A. Wakabayashi

Opis

Minimally invasive surgical techniques have the minimally invasive procedure allow for made a significant impact in lowering morbidity modifications in anesthetic technique. The and mortality and in changing the indications basics of this endeavor are well covered in this for operative surgery in the abdomen. Only section. recently have these minimally invasive tech- The basic techniques of thoracoscopic surgery niques been applied to the diseases of the tho- were developed in various diagnostic maneu- rax. The standard posterior lateral thoracotomy vers. It was this initial diagnostic application of infamous for its post-operative pain and atten- thoracoscopy which allowed these techniques to dant complications, is already being replaced in be developed and further therapeutic applica- a large number of situations by minimally inva- tions to be forwarded. This text nicely illustrates sive thoracoscopic techniques. current diagnostic techniques and their applica- This text by Gossot, Kleinmann and Levi pro- tion. vides basic information required for surgeons In addition, the most commonly applied thera- interested in approaching the most common peutic procedures in the pleura, lung and eso- phagus are well covered as are their indications diseases in the chest utilizing thoracoscopic techniques. The text is a well organized attempt and potential complications.

Spis treści

References.- Instrumentation for thoracoscopic surgery.- 1. Optical system.- 1.1 Endoscopes.- 1.2 Light source.- 1.3 Camera.- 2. Irrigation-suction system.- 3. Electrocautery.- 4. Lasers.- 5. Instrumentation.- 5.1 Trocars.- 5.2 Dissecting instruments.- 5.3 Other instruments.- 5.4 Suturing instrumentation.- 6. Conclusion.- References.- Basic techniques in thoracoscopic surgery.- 1. General considerations.- 2. Preparation.- 3. Trocar insertion.- 4. Endoscope.- 5. Instruments.- 6. Suturing techniques.- 6.1 Continuous suture.- 6.2 Interrupted suture.- 7. Stapling techniques.- 8. Chest drainage.- References.- Anesthesia for thoracoscopy.- 1. Pre-operative evaluation.- 2. Intra-operative monitoring.- 3. Anesthetic management.- 3.1 One lung ventilation.- 3.1.1 Management of hypoxemia.- 3.1.2 Management of large air-leak.- 4. Post-operative course.- References.- The role of thoracoscopy in the diagnosis of pleural pathology.- 1. Introduction.- 2. Pleural pathology without pleurisy.- 3. Pleural pathology with pleurisy.- 3.1 Orientations according to clinical aspects.- 3.2 Orientations according to the appearance of the pleural fluid.- 3.3 Orientations according to bacteriology.- 3.4 Orientations according to the biochemistry.- 3.5 Orientations according to cytology.- 4. The role of pleural needle-biopsy.- 5. The role of thoracoscopy.- 6. The role of thoracotomy.- 7. Conclusion.- References.- The role of thoracoscopy in the treatment of chronic pleural effusion.- 1. Introduction.- 2. Etiology.- 3. Methods of treatment.- 3.1 Thoracoscopic talc pleurodesis.- 3.2 Intrapleural injections.- 3.3 Other techniques.- 4. Indications.- 5. Conclusion.- References.- Thoracoscopic treatment of pneumothorax (A-D) A) Principles of the thoracoscopic approach.- 1. General considerations.- 2. Classification of pseudopneumocysts of the lungs.- 3. Treatment planning for PPC of the lungs.- 3.1 Spontaneous pneumothorax.- 3.2 Diffuse bullous emphysema.- 4. Equipment.- 4.1 Optic/video systems and instruments.- 4.2 Lasers.- 4.2.1 Carbon Dioxide Laser.- 4.2.2 Contact Sapphire Tip Nd: YAG Laser.- 5. Anesthesia.- 6. Techniques.- 6.1 Positioning and preparation.- 6.2 Chest entry.- 6.3 Lysis of adhesions.- 6.4 Techniques of ablating blebs or emphysematous bullae.- 6.4.1 Electrocautery.- 6.4.2 CO2 Laser.- 6.4.3 Sapphire Contact Tip Nd: YAG Laser.- 6.4.4 Endoloop ligation.- 6.4.5 Stapling.- 6.4.6 Suture ligation.- References.- B) Laser treatment of pseudopneumocysts of the lung.- 1. Spontaneous pneumothorax.- 1.1 Traditional treatment of spontaneous pneumothorax.- 1.1.1 Conservative treatment.- 1.1.2 Tube thoracostomy.- 1.1.3 Chemical pleurodesis.- 1.1.4 Pleurectomy and pleural abrasion.- 1.1.5 Thoracotomy and lung resection.- 1.2 Thoracoscopic treatment of spontaneous pneumothorax.- 1.2.1 Background.- 1.2.2 Techniques.- 1.2.3 Results.- 1.3 Treatment of ruptured diffuse bullous emphysema.- 2. Diffuse bullous emphysema.- 2.1 Traditional treatment of diffuse bullous emphysema.- 2.2 Laser thoracoscopic treatment of diffuse bullous emphysema.- 2.2.1 Background.- 2.2.2 Patient selection.- 2.2.3 Techniques.- 2.2.4 Post-operative care.- 2.2.5 Results.- References.- C) Laser pleurodesis.- 1. Introduction.- 2. Method.- 3. Results.- 4. Discussion.- References.- D) Pleural abrasion and pleurectomy.- 1. Introduction.- 2. Operative technique.- 2.1 Pleural abrasion under thoracic video-surgery.- 2.2 Percutaneous parietal pleurectomy.- 2.3 Intrapleural pleurectomy.- 3. Results.- 4. Discussion.- References.- Endoscopic procedures in lung and mediastinal surgery.- 1. Introduction.- 2. Common techniques and equipment used in endoscopic thoracic surgery.- 2.1 Equipment.- 2.2 Technique.- 2.3 Surgical approaches.- 2.4 Beginning the operation.- 2.5 Drainage.- 3. Resection of lung parenchyma.- 3.1 Pulmonary resection and pneumothorax.- 3.2 Pulmonary resection and interstitial pathology.- 3.2.1 Preliminary aspects.- 3.2.2 Technical consequences.- 3.3 Pulmonary resection and tumors.- 3.3.1 Preliminary aspects.- 3.3.2 Technical factors.- 4. Thoracoscopic surgery of the mediastinum.- 4.1 Preliminary aspects.- 4.2 Technical factors.- 5. Thoracoscopic surgery of the pericardium.- 6. Chest wall and miscellaneous aspects.- 7. Conclusion.- References.- Thoracoscopic treatment of empyema thoracis.- 1. General considerations.- 2. Assessment of lung expansibility.- 3. Debridement.- 4. Drain placement and post-operative irrigation.- 5. Biopsy.- 6. Foreign bodies.- 7. Conclusion.- References.- Thoracoscopic sympathectomy.- 1. Introduction.- 2. Historical perspective.- 3. Indications and patient selection.- 4. Technique.- 4.1 Preoperative investigations.- 4.2 Surgical technique.- 5. Results.- 6. Why thoracoscopic sympathectomy?.- References.- Thoracoscopic surgery of the esophagus.- 1. Esophagectomy.- 1.1 Technique.- 1.2 Discussion.- 2. Truncal vagotomy.- 2.1 Technique.- 2.2 Discussion.- 3. Other procedures.- 3.1 Benign tumors of the esophagus.- 3.1.1 Technique.- 3.1.2 Discussion.- 3.2 Miscellaneous.- 3.2.1 Treatment of esophageal perforation.- 3.2.2 Treatment of esophageal motor disorders.- 3.3.3 Other indications.- 4. Prospects in endoscopic esophageal surgery.- References.