Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Thoracoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMedDate not supplied

Quality of life after bilateral thoracoscopic splanchnicectomy: long-term evaluation in patients with chronic pancreatitis.

We prospectively evaluated quality of life and visual analogue scale pain scores after bilateral thoracoscopic splanchnicectomy in 55 patients with small-duct chronic pancreatitis and abdominal pain. The perioperative morbidity rate was 11% and there were no perioperative deaths. Four late deaths occurred (7%), and three patients were lost to follow-up. Patients were divided into those who had prior operative or endoscopic interventions (N = 38) and those who did not (N = 17). Preoperatively there were no significant differences between the two groups with regard to age, sex, etiology, pain score, or narcotic use. Pain score, narcotic use, and symptoms scales improved significantly in both groups at 3 and 6 months postoperatively (P < 0.0001). The group with no prior surgical or endoscopic intervention did significantly better initially (P < 0.007), and the improvements in their quality-of-life and pain scores continued for the remainder of the study. In contrast, quality-of-life and pain scores in patients who had undergone prior surgical or endoscopic intervention returned to baseline by 12 months postoperatively and remained poor throughout the remainder of the study. Bilateral thoracoscopic splanchnicectomy appears to work best in patients who have had no prior operative or endoscopic interventions.

Abdominal Pain↗
PubMed2004

[Video-assisted thoracoscopic sympathectomy for the treatment of facial flushing: ultrasonic scalpel versus diathermy].

OBJECTIVE: To evaluate the advantages of the ultrasonic scalpel compared to electrocoagulation in patients undergoing video-assisted thoracoscopic sympatholysis or sympathectomy for uncontrolled facial blushing. METHODS: Two hundred bilateral video-assisted thoracoscopic procedures to interrupt transmission in the thoracic sympathetic nerve were performed in 100 patients with incapacitating facial blushing. In 2 cases, the video-assisted approach was chosen because of pleural symphysis. The mean age of patients was 34 years (range: 15 to 67). The sympathetic chain was interrupted from the lower portion of the first thoracic ganglion through the third. RESULTS: All patients were discharged within 24 hours with the exception of one on whom an emergency thoracotomy had been performed. No complications were reported in the group in which a harmonic scalpel was used. One case of temporary Horner syndrome (4 months) and 3 cases of persistent chest pain (more than 2 weeks) were reported in the diathermy group. There were 9 cases of partial and asymptomatic pneumothorax that resolved without treatment or prolonged hospital stays. CONCLUSION: Dissection of the sympathetic nerve is accomplished more reliably and with better visualization with the ultrasonic scalpel. Peripheral lesions in lung parenchyma and adjacent tissues (intercostal vessels and nerves) are avoided, as is Horner syndrome, which can be caused by dispersion of heat. Use of the ultrasonic scalpel would also lead to a lower incidence of postoperative neuralgia.

Adolescent↗
PubMed1997

Anaesthetic management of a child undergoing thoracoscopic removal of a lung cyst.

The anaesthetic management of a child undergoing video-assisted thoracoscopic resection of a large lung cyst is described. In particular, we discuss the prolonged postoperative stay, which resulted from persistent pneumothorax, and his need for substantial analgesia up to the twelfth postoperative day-which seemed no shorter than might have been expected following a thoracotomy. While other workers have claimed advantages with thoracoscopic operations, in terms of reduced pain and morbidity, compared to traditional thoracotomy, we feel that one should be aware of the potential for severe postoperative pain in these patients.

Analgesia, Patient-Controlled↗
PubMed2004

Thoracoscopic renal denervation for intractable autosomal dominant polycystic kidney disease-related pain.

The authors report a case of intractable autosomal dominant polycystic kidney disease-related pain associated with normal renal function, treated with renal denervation. Renal denervation was performed via a thoracoscopic approach. The good medium-term result suggests that thoracoscopic sympatho-splanchnicectomy would be an attractive procedure for pain management in autosomal polycystic kidney disease.

Chronic Disease↗
PubMed2005

Thoracoscopic repair of esophageal atresia and tracheo-esophageal fistula.

Advancements in minimally invasive surgical techniques and instruments for neonates have allowed even the most complex neonatal procedures to be approached endoscopically. In 1998 the first successful thoracoscopic repair of an esophageal atresia was performed in a 2-month-old infant. One year later the first totally thoracoscopic repair of an atresia with distal fistula was realized. Over the ensuing 5 years these techniques have become more refined and widespread so that this technique is now being performed all over the world with excellent results, while avoiding the significant short- and long-term morbidity associated with thoracotomy in neonates.

Anastomosis, Surgical↗
PubMed2002

Thoracoscopic repair of tracheoesophageal fistula in newborns.

BACKGROUND: Advancements in minimally invasive surgery in neonates have allowed even the most complex neonatal procedures to be approached using these techniques. METHODS: During a period of 15 months, 8 patients born with a proximal esophageal atresia and a distal tracheoesophageal fistula underwent repair thoracoscopically. Weights ranged from 2.1 to 3.4 kg and operating times ranged from 55 to 120 minutes. RESULTS: All procedures were completed successfully thoracoscopically, and there were no operative complications. One patient had a small leak on day 4 that resolved spontaneously on day 8. All other patients were shown to have a patent anastomosis with no leak by Barium swallow on day 5. CONCLUSION: This initial report shows that esophageal repair in the neonate is technically feasible and may provide advantages in terms of exposure and esophageal length, as well as the recognized advantages of avoiding a thoracotomy.

Feasibility Studies↗
PubMed2002

Thoracoscopic aortopericardiosternopexy for severe tracheomalacia in toddlers.

BACKGROUND/PURPOSE: Aortosternopexy from a left anterolateral thoracotomy is the procedure of choice in severe tracheomalacia. The authors report an alternative technique of modified thoracoscopic aortopericardiosternopexy. METHODS: Thoracoscopy under mild CO2 insufflation (insufflation pressures 4 to 6 mm Hg) provides excellent access without selective intubation. The importance of visualizing the phrenic nerve, mobilization of the thymus without disrupting its vascular supply, and intraoperative bronchoscopy is stressed. The technique of passing the needle through the sternum and back is shown. In long segment tracheomalacia, not only the ascending aorta, but also the innominate artery and base of the pericardium are fixed to the sternum, and the effect is monitored by intraoperative bronchoscopy. RESULTS: This technique was dramatically successful in a 4-year-old boy with long segment tracheomalacia and as a redo procedure in a 2-year-old girl after failed open aortopexy. CONCLUSION: Thoracoscopic aortopexy seems to be as effective as open aortopexy.

Airway Obstruction↗
PubMed2000

Video assisted thoracoscopic bullectomy and acromycin pleurodesis: an effective treatment for spontaneous pneumothorax.

The introduction of video assisted thoracoscopic surgery (VATS) has led to the development of several endoscopic options for the management of spontaneous pneumothorax. We describe here our experience in the management of primary spontaneous pneumothorax (SP). We carried out 58 VATS procedures on 55 patients during the period 1993-95. There were six conversions to open thoracotomy because of dense adhesions in five patients and a large apical bulla of 20 cm in one. These patients were excluded from the study. The remaining 49 patients underwent 52 VATS procedures. There were 37 males and 12 females with a median age of 23 (range: 15-71) years. The indications for surgery were persistent SP for more than 5 days in 21 (40%), and recurrent SP in 31 (60%). Twenty-six procedures (25 patients) consisted of bullectomy alone (group 1; 1/1/93-30/9/94) and the next 26 procedures (24 patients) included chemical pleurodesis with 2 g of Acromycin (Lederle) in 10 ml of 0.9 normal saline (group 2; 1/10/94-31/12/95). Both groups had a mean follow up of 38 months (range: 36-40). Mean postoperative chest drainage in group 2 (3.1 +/- 1.09) was significantly shorter than in group 1 (4.7 +/- 1.0). Group 2 patients also had a shorter hospital stay (4.8 /- 1.08 vs. 6.76 +/- 1.09). There were five (20%) recurrences in group 1 while only one (4%) occurred in group 2. In view of these results we recommend the routine use of Acromycin pleurodesis in addition to thoracoscopic bullectomy.

Adolescent↗
PubMed1996

Thoracoscopic Splanchnicectomy for Chronic, Severe Pancreatic Pain.

Fourteen patients with pancreatic cancer, 2 with cancer of the papilla of Vater, and 14 with chronic pancreatitis were operated on with bilateral thoracoscopic splanchnicectomy caused by severe chronic pain. The median follow-up time was 13 months. Twenty patients were followed up for 3 months and 14 for at least 6 months. The surgical results were evaluated prospectively, both with visual analogue scale (VAS) and with documentation of the consumption of analgesics at elective follow-up after 1 week and 1, 3, 6, and 12 months postoperatively. All 30 patients stated that the characteristics of their pain had changed at recovery from anaesthesia, but only 6 of them reported immediate complete pain relief. All but 1 of the 14 patients with chronic pancreatitis had clearly reduced pain as evaluated by VAS 1 month after the operation, and this beneficial effect remained for the whole study period. Furthermore, the need for analgesics decreased. Also, in the 16 patients with cancer, there was on average a marked relief of pain from 1 week and onwards. The 6 cancer patients with survival more than 3 months had reduced pain for the remaining period of their lives. It seems that the final pain relief is persistent as is the reduced consumption of analgesics. There was no correlation between the number of cut nerves and pain relief as evaluated by VAS. Three patients were reoperated on for intrathoracic bleeding the evening after the operation, and one had transient pain located to one of the port sites. Otherwise, there were no postoperative complications. The operation time was short and the length of hospital stay in most patients was 24 hours or less. It was concluded that thoracoscopic splanchnicectomy appears to be a promising and relatively simple treatment for severe chronic pancreatic pain. Further studies are needed to establish its role in the management of intractable pancreatic pain.

Journal Article↗
PubMed1996

Introduction to Thoracoscopic Surgery: Indications, Basic Techniques, and Instrumentation.

Thoracoscopy is a useful tool for diagnosing and managing intrathoracic disease. With the new technologies in endoscopic surgery, a whole variety of diagnostic and therapeutic procedures is now possible thoracoscopically, which has led to an increase in both the therapeutic and diagnostic indications for thoracoscopic surgery. Thoracoscopy has therefore become an important part of the armamentarium of general thoracic surgery. Safe thoracoscopy includes the use of careful one-lung ventilation. New instruments are now available to allow thoracoscopy to be performed more easily. Thoracoscopy is a safe and effective technique that can be performed with minimal morbidity and excellent results.

Journal Article↗
PubMed1996

Thoracoscopic Surgery of the Spine.

Anterior approach to the thoracic spine has been limited by the morbidity of a thoracotomy. By a thoracoscopic approach, a majority of thoracic spine procedures can now be performed from the anterior approach including diskectomy for herniation, release for correction of spinal deformity and corpectomy for tumor. Although experience is limited and results still short term, the thoracoscopic approach appears to be a promising one for the treatment of thoracic spine disease.

Journal Article↗
PubMed2000

Thoracoscopic and laparoscopic esophagectomy.

Esophagectomy is both complex and challenging, and it may be associated with significant morbidity and mortality. With improvements in instrumentation and increasing experience with laparoscopic and thoracoscopic techniques, minimally invasive approaches to esophagectomy are being explored to determine feasibility, results, and potential advantages. Most of this experience has been with case studies or small series, with many surgeons using thoracoscopy in combination with standard laparotomy. Many of the patients have been carefully selected for these procedures because they have small tumors or high-grade dysplasia. Our technique for esophagectomy has evolved from a laparoscopic transhiatal approach to a combined laparoscopic and thoracoscopic approach. Our experience with this procedure has increased, and now we offer this approach to the majority of patients with resectable cancers. We review our operative technique and the results of surgery in our first 50 patients who underwent minimally invasive esophagectomy for cancer or high-grade dysplasia.

Adult↗
PubMed2000

[The indications for and results of video thoracoscopic sympathectomy].

BACKGROUND AND OBJECTIVES: Thoracoscopic sympathectomy, for years an effective way to treat mainly palmar and axilla hyperhidrosis, experienced a revival since the application of the principles of minimally invasive surgery. We report the personal experiences of three surgeons with this technique, as well as patients' view of the outcome. PATIENTS AND METHODS: Between January 1990 and November 1997, 73 procedures were performed in 43 patients (23 males, 20 females, mean age 38.1 years, range 15-82 years), and the outcome was prospectively studied. Palmar hyperhidrosis without axilla symptoms was the indication for the operation in 27 patients (54 sympathectomies), Raynaud's syndrome in 15 (18 sympathectomies), and causalgia in one. Thoracic ganglia 2-4 were always completely resected. Perioperative morbidity as well as patient satisfaction in the long-term course (standardized interview) 25.8 (1-77) months postoperatively were assessed. RESULTS: The complication rate in all 73 sympathectomies was 8.2%. Only two severe incidents were observed: in one patient intermittent Horner's syndrome (1.4%) occurred, and in another severe bleeding required conversion to open surgery (1.4%). Both complications occurred in the early study phase. The initial success rate in all 27 patients with hyperhidrosis was 100%. In 30% of these cases a mild partial relapse was observed, which did not interfere with their daily activities. 53% of the patients reported compensatory and 23% gustatory sweating. 9% would have refused the operation, had they known these side effects. In all patients with Raynaud's disease the ulcerations healed completely. At the time of the interview, two patients (13%) complained of painless relapses. They too stated that they had refused the operation, if they had known about the relapses. CONCLUSIONS: Even in the longer-term course, thoracoscopic sympathectomy is rated subjectively successful by 93% of patients after treatment of hyperhidrosis of the upper extremities, and by 87% of patients after treatment of Raynaud's disease, despite some untoward effects and partial relapses.

Adolescent↗
PubMed2000

Nerve stimulating system for peripheral nerve tumor resection under the thoracoscope.

The authors report a newly devised nerve stimulator and its clinical application in thoracoscopic surgery. The stimulator is a monopolar system, that has a long extension between the electrodes and the handle. The stimulator is inserted into the chest cavity through a portal, and is used to distinguish motor nerves from the surrounding tissue and to determine whether there is nerve involvement with tumor. The tumor is then safely and rapidly resected by thoracoscopic technique and the major nerves are spared. This method was used in two clinical cases, with excellent results obtained, and with no major complications.

Adult↗
PubMed2003

[Results of video-assisted thoracoscopic surgery for pneumothorax].

INTRODUCTION: Video-assisted thoracoscopic surgery has been used in the treatment of pneumothorax since 1990. There is still no general agreement regarding the procedure to obliterate the pleural space or regarding the indication for wedge resection if no blebs or bullae can be found. PATIENTS AND METHODS: Clinical records referring to 100 video- assisted thoracoscopic operations for pneumothorax, performed in Berlin-Buch between 1998 and 2001, were retrospectively evaluated with regard to the rate of recurrences and postoperative complications in connection with the operative procedure. There were 70 male and 28 female patients aged from 16 to 78 years. The mean age was 34 years. The statistical significance was evaluated by the McNemar-test. RESULTS: 74 patients showed a regular postoperative course. Severe postoperative complications occurred in 9 patients: re-operation via thoracotomy n=5 (postoperative bleeding n=2, recurrence n=2, persistent air-leak n =1); re-thoracoscopy n=3 (postoperative bleeding n=2, recurrence n=1), pleural empyema n=2. The complication rate was significantly higher (p < 0.001) in patients with underlying pulmonary diseases (secondary spontaneous pneumothorax) or thoracic surgery in their history. Depending on the intraoperative situation, the cause of pneumothorax and the patient's general condition the pleural space was obliterated by the following procedures: apical parietal pleurectomy (n=85), electro-pleurodesis alone (n= 7), electro-pleurodesis and pleural abrasion (n=3), talcum poudrage (n=2). The rate of major complications was lower (p < 0.001) when pleurectomy was performed 8.2 % (7/85) compared to those operations performed without pleurectomy 13.3 % (2/15). The rate of re-operations for recurrences/persistent air leaks or empyemas following persistent air leaks was significantly lower (p < 0.001) when wedge resection 3.75 % (3/80) had been performed compared with operations without wedge resection 10 % (2/20). DISCUSSION: Apical parietal pleurectomy and wedge resection of blebs or bullae are effective methods to prevent recurrences. Considering the specific complications of parietal pleurectomy alternative methods to obliterate the pleural space should be used depending on the intraoperative situation. Among other factors underlying pulmonary diseases or thoracic surgery in the patient's history strongly influence the postoperative outcome independently of the operative procedure.

Adolescent↗
PubMed2004

[The technique of laparoscopic-thoracoscopic esophageal resection for esophageal cancer--first experiences].

Esophageal resection for carcinoma is still associated with high mortality and morbidity. Minimally invasive techniques are regarded to reduce operative trauma. However, to date only few studies on minimally invasive esophageal resection have been published. We describe in detail the technique of combined laparoscopic and thoracoscopic esophageal resection with gastric-pull-up and conventional open cervical anastomosis for esophageal squamous carcinoma. Prone positioning of the patient with bilateral lung ventilation was used during the thoracoscopic part of the operation. Our first experiences in 5 patients confirm the feasibility of the technique. We did not observe any surgical related adverse incidences and found the typically advantages of minimally invasive surgery, such as early mobility, less pain and a comfortable cosmetic result in our patients. Although the number of procedures is to low to decide the value of minimally invasive surgery for esophageal cancer, we think it could be a promising technology to reduce mortality and morbidity for esophageal resection.

Carcinoma, Squamous Cell↗
PubMed1996

Thoracoscopic resection of an ectopic giant parathyroid adenoma: indication, technique, and three years follow-up.

We report on a case of a large mediastinal parathyroid adenoma resected successfully using a thoracoscopic approach. Apart from a slight hypocalcemia, which normalized within three days, the patient recovered quickly and was discharged with an excellent functional and cosmetic result. 36 months after the operation no symptoms of recurrency of hyperparathyroidism were evident and laboratory results were normal. Complete thoracoscopic removal of mediastinal parathyroid adenoma seems to be possible as demonstrated by this example.

Adenoma↗
PubMed1999

Thoracoscopic resection of intrathoracic vagus neurofibroma.

A thoracoscopic resection of mediastinal neurofibroma originating from the intrathoracic vagus nerve was successfully performed in an 18-year-old female. This report reviews the clinical and morphological features of intrathoracic vagus neurofibroma. Often neurofibroma has multiple lesions and/or multinodular shape. Thoracoscopic resection is a useful treatment for patients with intrathoracic neurofibroma, although careful observation is necessary when performing a radical resection.

Adolescent↗