Hyun Koo Kim, MD PhD, Ho Kyung Sung, MD, Hyun Joo Lee, RN, Jiae Min, RN, Young Ho Choi, MD PhD. College of Medicine, Korea University Guro Hospital
Background: Single incision laparoscopic surgery (SILS) has recently been used by general surgeons to perform cholecystectomy and pre-peritoneal hernia repair. The SILS approach with SILS port had the potential merits of decreasing the duration of anesthesia by using single-lumen endotracheal tube intubation with CO2 gas insufflation. We performed single incision thracoscopic surgery for primary spontaneous pneumothorax using a SILS port with CO2 gas insufflation and evaluated the feasibility and safety of this procedure.
Methods: Thirty patients with primary spontaneous pneumothorax underwent bleb resection with chemical and mechanical pleurodesis in our clinic, from October 2010 to August 2011. Single-lumen endotracheal tube with CO2 gas insufflation was used for obtaining the optimal surgical field. An incision of 2.5 cm was made at the previous closed thoracotomy site. A single flexible port (SILS port) was placed to access the thoracic cavity, and a 5 mm thoracoscopy, articulating gasper and endoGIA stapler were introduced through port channels.
Results: Thirty-one male patients (mean age 21.2 ± 7.79 years) were enrolled in this study. The mean time from endotracheal intubation to the incision was 15.2 ± 5.28 minutes (range 9~25 minutes), the mean operation time was 33.2 ± 15.38 minutes (range 13~77 minutes) and the total time under anesthesia was 59.3 ± 13.16 minutes (range 41~95 minutes). There were no wound infections, early recurrences or readmissions. The chest tube was removed on average at postoperative day 3.6 ± 1.3 (range 2~5 days) and patients were discharged from the hospital without complications on average at postoperative day 4.5 ± 1.3 (range 3~6 days). During the mean follow-up period of 4.9 ± 3.15 months (range 0.6~10.4 months), there was no recurrence on the side that underwent surgery.
Conclusions: Single incision thracoscopic surgery for primary spontaneous pneumothorax using a SILS port under single-lumen endotracheal tube intubation with CO2 gas insufflation was technically feasible. Further work and development of a specific thoracic single port are needed to refine the use and advantages of this procedure.
Session Number: Poster – Poster Presentations
Program Number: P529