Simple lung retraction method for uniportal video-assisted thoracoscopic surgery.

Yasushi Mizukami,Hirofumi Adachi,Ryunosuke Maki

doi:10.1093/jscr/rjab465

Abstract

In conventional multiportal video-assisted thoracoscopic surgery, devices such as cotton-tipped applicators are used instead of graspers to avoid injuring the fragile lung tissue while stabilizing the lung and securing the surgical visual field. However, in uniportal video-assisted thoracoscopic surgery, which requires the simultaneous use of multiple instruments, the instruments tend to interfere with each other during the procedure because they share a single incisional port. Here, we describe a simple, easy and cost-effective lung retraction technique using cotton swabs to solve the problem. We present this technique and comment on its advantages, including decreased cost and improved surgical visualization.

Highlights

In uniportal video-assisted thoracoscopic surgery, which requires the simultaneous use of multiple instruments, the instruments tend to interfere with each other during the procedure because they share a single incisional port
Uniportal video-assisted thoracoscopic surgery (UVATS), which has been reported to reduce the duration of hospital stay and postoperative pain, is performed globally [1]
Diego et al reported the use of long suction cannula, vessel sealing devices and long graspers to provide an adequate field of view while performing the surgical resection [2]

Summary

INTRODUCTION

Uniportal video-assisted thoracoscopic surgery (UVATS), which has been reported to reduce the duration of hospital stay and postoperative pain, is performed globally [1]. When performing lobectomy or segmentectomy using UVATS, we sometimes encounter problems such as the lungs encroaching on the surgical field, making adequate exposure of the vessels and bronchi difficult. Diego et al reported the use of long suction cannula, vessel sealing devices and long graspers to provide an adequate field of view while performing the surgical resection [2]. We describe an alternative, simple, easy and cost-effective lung retraction technique using cotton swabs. The heads of two cotton swabs are connected by a silk thread about 7-cm long that the length can be adjusted as needed (Fig. 1). When the connected swabs are pulled apart adequately, the silk thread becomes taut, such that the cotton heads and silk thread can retract the lung, creating a good surgical field. We believe that our technique is effective for use during UVATS

DISCUSSION

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