A Video-Assisted Thoracoscopic Approach to Transaxillary First Rib Resection

2015 ◽  
Vol 10 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Harmik J. Soukiasian ◽  
Daniel Shouhed ◽  
Derek Serna-Gallgos ◽  
Robert McKenna ◽  
Vahak J. Bairamian ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Thoracoscopic Surgery ◽  
Invasive Approach ◽  
Thoracoscopic Approach ◽  
Rib Resection ◽  
Video Assisted ◽  
First Rib ◽  
The Mean ◽  
First Rib Resection ◽  
Video Assisted Thoracoscopic Surgery

Objective Thoracic outlet syndrome (TOS) can be associated with neurologic, arterial, or venous deficiencies. When nonsurgical treatment has failed to adequately palliate TOS, surgical intervention is indicated. The supraclavicular and transaxillary approaches are currently the most commonly used approaches for first rib resection, yet little has been reported to date on outcomes of minimally invasive procedures, such as video-assisted thoracoscopic surgery (VATS). The purpose of this article was to describe a minimally invasive approach to TOS and the associated outcomes. Methods This study is a retrospective analysis of a prospectively maintained database. Patients who failed nonsurgical therapy for TOS were referred to our practice for evaluation of surgery with a VATS minimally invasive first rib resection. Between 2001 and 2010, 66 VATS procedures were performed on 58 patients (41 women, 17 men). Patients were followed postoperatively for a mean time of 13.5 months. Results Forty-one patients were women (70.7%), and the mean age was 40.5 years, with a patient age range of 17 to 59 years. The mean length of hospital stay was 2.47 days; median length of stay was 2 days. There were a total of eight complications (12.1%). There were no mortalities. Conclusions Video-assisted thoracoscopic surgery first rib resection for TOS is another feasible option for TOS, which can be added to the armamentarium of the thoracic surgeon. The outcomes associated with our technique are comparable with the outcomes related to other current standards of care.

A Video-Assisted Thoracoscopic Approach to Transaxillary First Rib Resection

2015 ◽  
Vol 10 (1) ◽  
pp. 21-26
Author(s):  
Harmik J. Soukiasian ◽  
Daniel Shouhed ◽  
Derek Serna-Gallgos ◽  
Robert McKenna ◽  
Vahak J. Bairamian ◽  
...  
Keyword(s):  
Thoracoscopic Approach ◽  
Rib Resection ◽  
Video Assisted ◽  
First Rib ◽  
First Rib Resection

Robotic En Bloc First-Rib Resection for Paget-Schroetter Disease, a Form of Thoracic Outlet Syndrome Technique and Initial Results

2012 ◽  
Vol 7 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Farid Gharagozloo ◽  
Mark Meyer ◽  
Barbara J. Tempesta ◽  
Marc Margolis ◽  
Eric T. Strother ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Subclavian Vein ◽  
Preoperative Assessment ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Invasive Approach ◽  
Rib Resection ◽  
First Rib ◽  
First Rib Resection

Objective First-rib resection is a key component of the treatment of Paget-Schroetter disease. There are many controversies regarding the management of this disease. We report a safe, effective, minimally invasive robotic transthoracic approach for resection of the first rib. Methods Over an 8-month period, five patients underwent robotic first-rib resection. Preoperative assessment included physical examination and bilateral venous angiography. On a thoracoscopic platform using three 2-cm incisions and one 1-cm incision, the robot was used to dissect the first rib and divide the scalene muscles. Success of the first-rib resection was assessed by postoperative venous angiography. Results There were four men and one woman. Mean age was 34.6 ± 10 years. Mean operative time was 195 ± 24.6 minutes. There were no complications and no mortality. All patients had a patent subclavian vein on the postoperative venogram and were anticoagulated with warfarin for 3 months. At a median follow-up of 12 months, all patients had an open subclavian vein for a patency rate of 100%. Conclusions Robotic thoracoscopic first-rib resection represents a feasible minimally invasive approach to en bloc resection of the first rib. This technique minimizes the risk of neurovascular complications that are associated with conventional techniques.

scholarly journals Arterial Thoracic Outlet Syndrome Treated Successfully with Totally Endoscopic First Rib Resection

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Sofoklis Mitsos ◽  
Davide Patrini ◽  
Sara Velo ◽  
Achilleas Antonopoulos ◽  
Martin Hayward ◽  
...  
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Thoracoscopic Surgery ◽  
Signs And Symptoms ◽  
Rib Resection ◽  
First Rib ◽  
Endoscopic Video ◽  
First Rib Resection ◽  
Neurovascular Structures ◽  
Arterial Thoracic Outlet Syndrome ◽  
Video Assisted Thoracoscopic Surgery

Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection.

Nonintubated Uniportal Thoracoscopic Thymectomy with Laryngeal Mask

2019 ◽  
Vol 68 (05) ◽  
pp. 450-456 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Yang Sun
Keyword(s):  
Thoracoscopic Surgery ◽  
Anterior Mediastinum ◽  
Laryngeal Mask ◽  
Double Lumen Tube ◽  
Perioperative Outcomes ◽  
Video Assisted ◽  
Incision Size ◽  
The Mean ◽  
End Tidal ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective To investigate whether laryngeal mask anesthesia had more favorable postoperative outcomes than double-lumen tube intubation anesthesia in uniportal thoracoscopic thymectomy. Methods Data were collected retrospectively from December 2013 to December 2017. A total of 96 patients with anterior mediastinum mass underwent nonintubated uniportal video-assisted thoracoscopic thymectomy with laryngeal mask, and 129 patients underwent intubated uniportal video-assisted thoracoscopic thymectomy. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes between nonintubated uniportal video-assisted thoracoscopic surgery (NU-VATS) and intubated uniportal video-assisted thoracoscopic surgery (IU-VATS) were compared. Results In both groups, incision size was kept to a minimum, with a median of 3 cm, and complete thymectomy was performed in all patients. Mean operative time was 61 minutes. The mean lowest SpO2 during operation was not significantly different. However, the mean peak end-tidal carbon dioxide in the NU-VATS group was higher than in the IU-VATS group. Mean chest tube duration in NU-VATS group was 1.9 days. Mean postoperative hospital stay was 2.5 days, with a range of 1 to 4 days. Time to oral fluid intake in the NU-VATS group was significantly less than in the IU-VATS group (p < 0.01). Several complications were significantly less in the NU-VATS group than in the IU-VATS group, including sore throat, nausea, irritable cough, and urinary retention. Conclusion Compared with intubated approach, nonintubated uniportal thoracoscopic thymectomy with laryngeal mask is feasible for anterior mediastinum lesion, and patients recovered faster with less complications.

scholarly journals Uniportal video-assisted thoracoscopic carinal resections: technical aspects and outcomes

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i58-i64
Author(s):  
Dmitrii Sekhniaidze ◽  
Diego Gonzalez-Rivas ◽  
Pavel Kononets ◽  
Alejandro Garcia ◽  
Vladimir Shneider ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Thoracoscopic Surgery ◽  
Morbidity Rate ◽  
Surgical Time ◽  
Technical Aspects ◽  
Video Assisted ◽  
The Mean ◽  
Clinic Hospital ◽  
Blood Loss Volume ◽  
Video Assisted Thoracoscopic Surgery

Abstract OBJECTIVES Important benefits in uniportal video-assisted thoracoscopic surgery (VATS) for lung cancer have recently been achieved. However, the use of this technique for complex sleeve procedures is limited. We describe the technical aspects of and patient outcomes following carinal resections using uniportal VATS. METHODS Since 2015, 16 sleeve carinal resections, including 11 right pneumonectomies, 4 right upper lobectomies and 1 lung-sparing carinal resection, have been performed at the Regional Clinic Hospital, Tyumen, Russia. RESULTS The mean surgical time was 215.9 ± 67.2 min (range 125–340 min). The mean blood loss volume was 256.3 ± 284.5 ml (range 50–1200 ml). There was 1 case of conversion to thoracotomy. The morbidity rate was 25%, and the mortality rate was 0%. The median overall survival was 38.6 ± 3.5 months. CONCLUSIONS The use of uniportal VATS for carinal resections in certain patients allows for radical resections with low rates of morbidity and mortality.

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