Thoracoscopy: beyond the key hole

Background Lateral thoracotomy or median sternotomy causes significant morbidity. Thoracoscopy reduces the morbidity of the incision and provides a clear and magnified display of anatomy. It involves a learning curve.

Objectives To evaluate the safety, efficacy and advantages of thoracoscopy.

Method A retrospective analysis of 67 thoracoscopic procedures performed at the university surgical unit, Teaching Hospital, Peradeniya.

Results The total number of 67 procedures included thymectomy, lymph node biopsy, lymph node dissection, excision of retrosternal goitre, sympathectomy, splanchnicectomy, oesophagectomy, lung biopsy and diagnostic procedures. The time taken was acceptable with minimum blood loss and selective use of intercostal drainage. There were no conversions. Intensive care was needed only for oesophagectomy, thymectomy and excision of retrosternal goiter. The need for narcotic analgesics was minimal. Feeding, mobilization and discharge from hospital were early except after oesophagectomy. There was a mortality of 13% in the oesophagectomy group. No morbidity or mortality was recorded among others.

Conclusion Thoracoscopy permitted a wide range of surgeries to be done safely with reduced morbidity.

DOI:http://dx.doi.org/10.4038/sljs.v32i1.6869

The Sri Lanka Journal of Surgery 2014; 32(1): 29-34