Totally endoscopic subxiphoid pericardioscopy: early steps with a new surgical tool
| Autor: | Andrea Valeri, Avio Maria Perna, Gabriele Giunti, Pierluigi Stefàno, Gian Franco Gensini, Alessandro Tedone, Lucio Braconi, Riccardo Codecasa, Giuseppe Manca |
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| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Swine MEDLINE Endoscopic surgery Pericardial effusion Pericardial Effusion Internal medicine Animals Humans Medicine Pericardium medicine.diagnostic_test business.industry Endoscopy Middle Aged Hepatology Pericardial Window Techniques medicine.disease Surgery medicine.anatomical_structure Surgery Computer-Assisted Echocardiography Models Animal Female Xiphoid Bone business Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 23:444-446 |
| ISSN: | 1432-2218 0930-2794 |
| DOI: | 10.1007/s00464-008-9877-0 |
| Popis: | Pericardial pathology still has challenging diagnostic and treating issues. To reduce surgical trauma and pain for the patient, the authors developed a totally endoscopic echo-guided approach for both diagnostic and operative pericardioscopy.Three steps moved from animal model (8 pigs) through concomitant open-chest interventions (7 patients) to closed-chest interventions for 10 patients with a diagnosis of severe pericardial effusion.A lesion of the right ventricle in one patient (10%) due to imperfect preoperative pericardial visualization needed sternotomy for repair. All the patients, except the aforementioned one, underwent surgery with local anesthesia or mild sedation. No method-related mortality was reported.The closed-chest nonintrapleural approach to the pericardium may represent an evolution, with a positive impact on the treatment of this pathology. Therapeutic maneuvers with rigid instruments in nonintubated patients are possible. Accurate patient selection and technical refinement should increase the safety and effectiveness of the method. |
| Databáze: | OpenAIRE |
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