title: Cervical video-assisted thoracoscopic surgery using a flexible endoscope for bilateral thoracoscopy.
abstract: Video-assisted thoracoscopic surgery (VATS) has become the standard of care for pleural evaluation, drainage, and pleurodesis. The major limitations to standard VATS techniques include intercostal pain and the unilateral nature of the procedure. We report on a cervical VATS approach for bilateral thoracoscopy, pleural biopsy, and talc pleurodesis using a flexible video endoscope without any intercostal incision. A 64-year old male with peritoneal carcinomatosis was noted to have significant bilateral pleural effusions. A cervical video-assisted thoracoscopic surgery (C-VATS) procedure was performed through a 2-cm cervical incision using a sterile flexible gastroscope. Bilateral thoracoscopy, pleural drainage, pleural biopsies, lung biopsy, and talc pleurodesis were performed. No thoracic intercostal incisions were performed. Total operative time was 48 minutes. The procedure was successful and the recovery was uneventful. The patient was discharged 4 days after the procedure. C-VATS is an extremely minimally invasive procedure. It avoids intercostal incisions and allows for bilateral pleural procedures through a single small cervical incision.
authors.affiliation: CHUM Endoscopic Tracheobronchial and Oesophageal Center (C.E.T.O.C.), Division of Thoracic Surgery, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada. moishe.liberman@umontreal.ca
authors.forename: Moishe
authors.initials: M
authors.lastname: Liberman
authors.forename: Mohamed
authors.initials: M
authors.lastname: Khereba
authors.forename: Eric
authors.initials: E
authors.lastname: Goudie
authors.forename: Mehdi
authors.initials: M
authors.lastname: Tahiri
authors.forename: Jessica
authors.initials: J
authors.lastname: Forcillo
authors.forename: Alain
authors.initials: A
authors.lastname: Gauthier
authors.forename: Vicky
authors.initials: V
authors.lastname: Thiffault
authors.forename: André
authors.initials: A
authors.lastname: Duranceau
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ferraro
mesh_terms: D001706:Biopsy; D019723:Endoscopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D018700:Pleurodesis / Q000295:instrumentation*; D012597:Sclerosing Solutions / Q000008:administration & dosage; D013627:Talc / Q000008:administration & dosage; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy / Q000295:instrumentation*
chemical_list: D012597:Sclerosing Solutions; D013627:Talc