Minimal access extrapleural esophagoesophagostomy.
Publication/Presentation Date
6-1-2004
Abstract
BACKGROUND/PURPOSE: Minimal access repair of esophageal atresia is gaining acceptance but usually requires a transpleural approach. An extrapleural approach using a 2-cm incision has been described. The purpose of this study was to develop a less-invasive approach to extrapleural esophagoesophagostomy.
METHODS: A 5-8 kg nonsurvivor piglet model was used to develop this technique. The extrapleural dissection was performed under direct vision utilizing transpleural thoracoscopy. A 16-gauge needle and a spatula were used to create an extrapleural space that allowed insertion of a 3-mm trocar. An 8F catheter with a 3-mL balloon was inserted through the trocar and inflated to create enough space to exchange it for a 5-mm trocar. A 12F catheter with a 5-mL balloon was inserted through the 5-mm trocar and inflated to enlarge the space. These steps were repeated at each of the 3 extrapleural port sites until one confluent extrapleural space was created that did not communicate with the transpleural port site. Esophagoesophagostomy was then completed within the extrapleural space.
RESULTS: Thoracoscopic guidance and balloon dissection facilitated creation of an adequate extrapleural working space.
CONCLUSIONS: This new minimal access extrapleural approach offers an attractive alternative to the currently described minimal access approaches to esophagoesophagostomy.
Volume
39
Issue
6
First Page
855
Last Page
858
ISSN
1531-5037
Published In/Presented At
Tantoco, J., Rossman, J., Dixey, L., Glick, P., & Hollands, C. (2004). Minimal access extrapleural esophagoesophagostomy. Journal of pediatric surgery, 39(6), 855–858. https://doi.org/10.1016/j.jpedsurg.2004.02.024
Disciplines
Medicine and Health Sciences
PubMedID
15185212
Department(s)
Department of Surgery
Document Type
Article