VIDEOENDOSCOPIC PROCEDURES IN THORACIC-SURGERY - TECHNICAL ASPECTS AND REPORT OF REMOVAL OF A MEDIASTINAL CYST

Current videoendoscopic technology and percutaneous techniques of expo sure and dissection have been successfully applied to abdominal surger y with favorable results. Application of this technology to our practi ce of thoracic surgery is the basis of this report. Video-assisted tho racic surgery was performed in 36 patients for the following indicatio ns: Raynaud's syndrome, undefined pulmonary nodule, persisting spontan eous pneumothorax, T-1 bronchial carcinoma, and mediastinal cyst. Vide oendoscopic surgical procedures were accomplished using double-lumen e ndotracheal anaesthesia and a percutaneous stapling device. Procedures performed using this technique include thoracic sympathectomy, wedge or keel excision, blebectomy, lung apex stapling, parietal pleurectomy , and dissection of the mediastinal cyst. Median operating time was 45 min (range, 15 to 90 min). Tissue diagnosis was obtained in all patie nts. Median diameter of excised nodules was 10 mm (range, 7 to 70 mm). There were no operative deaths. The single complication was a prolong ed air leak. This new method of thoracic surgery appears to benefit th e patients. For us it proved a secure way to perform thoracic surgery. Our case of removal of a benign cyst in the posterior mediastinum sho ws that video-assisted thoracic surgery has expanding applications in the field of general thoracic surgery.