Video-Thoracoscopy
"We use the videothoracoscopic technique in approximately 50% of the surgeries performed".
DR. VALERIO PERNA CODIRECTOR. THORACIC SURGERY DEPARTMENT
Video-Thoracoscopy is a surgical technique that consists of the exploration of the space between the parietal and visceral pleura (which covers the lung).
Likewise, structures located in the mediastinum (thymus, esophagus, lymph nodes, pericardium or tumors of neurogenic origin) can be accessed through this procedure.
This technique is very useful in the diagnosis of pleural, pulmonary and certain mediastinal lesions, since it allows both biopsy and, in some cases, complete removal.
When is videothoracoscopy indicated?
This technique facilitates the performance of other therapeutic procedures such as:
- Resection of subpleural bullae in the treatment of patients with recurrent pneumothorax.
- Talc pleurodesis (pleural abrasion in the case of recurrent massive pleural effusion).
- Thoracic sympathectomy (section of the sympathetic ganglion chain in patients with palmoplantar hypersudoration).
Most frequent indications of this test:
- Pleural and mediastinal biopsies, etc.
- Lung Cancer
- Pneumothorax
- Lung Node
- Peripheral Lung Metastases
Do you have any of these diseases?
You may need to have a videothoracoscopy
How is videothoracoscopy performed?
It is practiced under general anesthesia and usually with selective bronchial intubation.
The objective of this intervention is to form an interpleural space in order to introduce the trocars through which the optics (which allow images to be obtained) and the rest of the endoscopic surgical material are introduced.
The average duration of the operation is one and a half hours, although it can be extended in the case of having to remove lung nodules that are difficult to access.
The necessary hospital stay varies depending on the time it takes to remove the chest drain, which is usually done 24 or 48 hours after the operation.
If it is necessary to extend the incision (conversion to thoracotomy or open surgery), the average hospital stay is 7 days.
Since the use of general anesthesia is necessary, the usual preoperative tests will be performed:
- Hemogram
- Coagulation, group and Rh tests
- Chest X-ray
- Electrocardiogram (with cardiological evaluation in the case of patients over 60 years old or with a previous heart disease)
- Respiratory function tests
The only preparation required is fasting for six hours prior to the procedure. In addition, before the operation, the nursing staff will instruct the patient in the knowledge of active respiratory physiotherapy techniques.
In the case of having to biopsy pulmonary nodules that are difficult to access by CT (nodules that are not superficial and cannot be seen or palpated with the thoracoscopy forceps), it may be necessary to place a guide wire under CT control on the same day as the operation, under local anesthesia.
This intervention hardly presents any complications, except those typical of any surgical intervention on the thorax such as hemorrhage, infection, pneumothorax and subcutaneous emphysema.
As it is a minimal incision, it considerably reduces post-operative pain and the number of days of hospital stay.
If it is not possible to perform the procedure by the minimally invasive route (because it is an inaccessible nodule or for other technical reasons), the incision should be extended (posterolateral or axillary thoracotomy). This occurs in very few cases, since an adequate selection of patients must be made beforehand.
Where do we do it?
IN NAVARRE AND MADRID
The Thoracic Surgery Service
of the Clínica Universidad de Navarra
The Thoracic Surgery Service of the Clinica Universidad de Navarra is composed of a team of medical specialists, nurses and health professionals specialized in the management of thoracic pathology.
In most procedures we perform minimally invasive surgery or videothoracoscopy for the diagnosis and treatment of numerous pleural, pulmonary and mediastinal lesions.
We maintain a close collaboration with other departments of the Clinic, among which Medical Oncology, Pneumology, Pathological Anatomy, Internal Medicine and ICU stand out.
Treatments we perform
- Lung cancer surgery
- Hyperhidrosis and facial flushing surgery
- Pleural surgery
- Mediastinal surgery
- Lung emphysema surgery
- Pleural mesothelioma surgery
- Lung metastasis surgery
Why at the Clinica?
- Medical specialists who are national references.
- Specialized nursing team.
- We work together with Pneumology and Medical Oncology.
