VIDEO SURGICAL TECHNIQUE FOR INTERRUPTION OF PATENT DUCTUS-ARTERIOSUSIN CHILDREN AND NEONATES

Classical surgical interruption of PDA has partially been replaced by trans catheter endovascular closure since 1971. We describe a new tech nique for PDA closure by video surgery. With the patient under general anesthesia and intubated, two 5 mm holes were made through the left t horacic wall. A video camera and specially devised surgical tools were introduced, such as scissors, dissecting forceps, clip appliers. The ductus was dissected and two titanium clips were applied, completely i nterrupting the ductus. 282 patients were operated on from April 1991. Mean age was 20 months (range 1 month to 17 years) and mean weight wa s 13 kg (range 1.2 to 65 kg) Twenty-one had associated lesions not nec essitating immediate surgical treatment. All had successful closure of the patent ductus with the video-assisted technique. 6 patients had r ecurrent laryngeal nerve injury (5 transient, 1 permanent). The usual hospital stay was from 48h to 72h. There were no other complications a nd no deaths. Video surgery is a rapid, safe and successful technique for closure of the patent ductus arteriosus. This technique is feasibl e in low-weight and premature infants.