Thoracoscopy for spontaneous pneumothorax 2.10 version with bleb stapling and pleurectomy.
A series of 25 Thoracoscopy procedures were performed for spontaneous pneumothorax over the past 2 1/2 years. The indications for the procedure were recurrent pneumothorax or choice of patient for definitive care. The procedure developed over the period of 2 1/2 years, and the procedure included a thoracoscopy, stapling of apical blebs, and apical pleurectomy. The complication rate was 3% and limited to local wound problems. There was one recurrent pneumothorax in a patient who did not have the pleurectomy as a part of the procedure. This was early on in the experience, when it was felt that pleural abrasion would be adequate. Since that time, a formal apical pleurectomy has been done with each of these procedures. No further recurrences have been noted over the 2 1/2 year period of time. The procedure includes one port at the anterior axillary line, fifth intercostal space, one port in the axilla, third intercostal space, and one port in the midclavicular line, fourth intercostal space. A 30 degree and angled scope is sometimes used for better visualization. The Endo GIA (US Surgical or equivalent Ethicon stapler) is used to staple the blebs, and the pleurectomy is done through the two non-video ports.
John F. Kennedy Medical Center, Edison, New Jersey.
B R
BR
Ellman
J W
JW
Ferrante
R N
RN
Tiedemann
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001768:Blister / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010994:Pleura / Q000601:surgery*; D011030:Pneumothorax / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications; D012008:Recurrence; D017792:Surgical Stapling; D013906:Thoracoscopy