Massachusetts General Hospital Illustrated Tips and Tricks in Thoracic Surgery

 

Originating from the esteemed Massachusetts General Hospital and edited by Drs. Yolonda L. Colson and Christopher R. Morse, this new volume in the Illustrated Tips and Tricks series provides succinct, precise information from a wide range of experts on tackling technical problems in thoracic surgery. Practical, hands-on content conveys knowledge gained from years of surgical experience, including nuggets of wisdom unique to this institution. Drawings and operative photos are used liberally throughout the book to illustrate surgical techniques and provide a handy visual complement to the text. 

 

Table of Contents:

 

LUNG/AIRWAY

1 • Massive Hemoptysis

Background

Key Definitions

Diagnosis

Etiology

Perioperative Considerations

General Management

Airway Management

Technique

Bronchoscopy

Interventional Radiology

Surgical Management

Postoperative Care

2 • Lung Volume Reduction Surgery

Introduction

Perioperative Considerations

Patient Selection

Patient Preparation

Technique

Instruments and Equipment for Thoracoscopic LVRS

Positioning

Video-Assisted (VATS) Technique

Open Technique

Postoperative Care

3 • Image-Guided Minimally Invasive Wedge Resection of Small Lung Nodules

Perioperative Considerations

Patient Positioning

Instruments and Equipment

Technique

4 • Segmentectomy: Robotic, Video-Assisted Thoracoscopic Surgery, and Thoracotomy

Perioperative Considerations

Instruments and Equipment

Positioning

Technique

Right Apical (S1) Segmentectomy

Superior (S6) Segmentectomy

Basilar (S7-10) Segmentectomy

Left Upper Division (S1-3) Segmentectomy

Lingular (S4-5) Segmentectomy

Postoperative Care

5 • Right Upper Lobectomy: Robotic/Video-Assisted Thoracic Surgery/Thoracotomy

Introduction

Perioperative Considerations

Anesthesia and Positioning

Instruments and Equipment

Technique

Open

Video-Assisted Thoracic Surgery

Robotic-Assisted

Operative Approach—Posterior to Anterior

Operative Approach—Anterior to Posterior or “fissureless” Approach

Postoperative Care

6 • Right Middle Lobectomy: Minimally Invasive and Open Techniques

Perioperative Considerations

Instruments and Equipment

Positioning and Anesthesia

Technique

Robot-Assisted Thoracoscopic Surgery

Video-Assisted Thoracoscopic Surgery

Open

Postoperative Care

7 • Right Lower Lobectomy: Robotic/Video-Assisted Thoracic Surgery/Thoracotomy

Perioperative Considerations

Instruments and Equipment

Anesthesia and Patient Positioning

Technique

Robot-Assisted Thoracoscopic Surgery

General Concepts for Robotic Lobectomy

Key Steps for RATS vs VATS Right Lower Lobectomy

Video-Assisted Thoracoscopic Surgery

Thoracotomy

Postoperative Care

8 • Left Upper Lobectomy: Robotic-Assisted Surgery/Video-Assisted Surgery/Thoracotomy

Perioperative Considerations

Instruments and Equipment

Anesthesia

Positioning

Robotic Positioning

Technique

Robot-Assisted

Top-Down Modification

Video-Assisted Thoracic Surgery

Open

Preoperative, Intraoperative, and Postoperative Care

Preoperatively

Intraoperatively

Postoperatively

9 • Left Lower Lobectomy

Perioperative Considerations

Instruments and Equipment

Positioning

Technique

Resection

Postoperative Care

10 • Pneumonectomy: Robotic/Video-Assisted Thoracic Surgery/Thoracotomy

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Postoperative Care

11 • Sleeve Resection/Bronchoplasty via Minimally Invasive/Thoracotomy

Overview

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Open Technique via Posterolateral Thoracotomy

Minimally Invasive Robotic Technique

Postoperative Care

Complications

12 • Anterior and Posterior Approach to Superior Sulcus Tumors

Perioperative Considerations

Preoperative Evaluation

Technique

Posterior Approach

Anterior Approach

Anterior Transmanubrial Approach

13 • Principles of Mediastinal Lymph Node Dissection

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Port Placement

Nodal Stations

Right Paratracheal Lymph Node Dissection (2R and 4R)

Left Paratracheal Lymph Node Dissection

Aortopulmonary Lymph Nodes (Level 5/6 Lymph Nodes)

Subcarinal Lymph Node Dissection (Level 7)

Inferior Pulmonary Vein Lymph Node Dissection (9R and 9L)

Postoperative Care

14 • Lung Decortication: Open Thoracotomy and Video-Assisted Thoracoscopic Surgery

Background

Perioperative Considerations

Anesthesia and Positioning

Instruments and Equipment

Technique

Open

Video-Assisted

Postoperative Care

15 • Tracheal Resection and Reconstruction/Postintubation Tracheal Stenosis

History

Airway Management on Presentation (Acute)

Perioperative Considerations

Contraindications to Tracheal Surgery

Positioning

Surgical Technique

Anastomotic Techniques

Postoperative Care

16 • Tracheostomy

Perioperative Considerations

Indications

Contraindications

Patient Positioning (Figure 16.1)#ff16-1

Instruments and Equipment

Technique

Open Surgical Tracheostomy

Percutaneous Tracheostomy

Complications

Immediate Complications (Perioperative Period)

Delayed Complications (Postoperative Period

Late Complications (Late Postoperative Period >7 days)

17 • Postpneumonectomy Bronchopleural Fistula

Perioperative Considerations

Management

Acute BPF—0 to 7 Days Postoperative (Implies Technical Failure)

Intermediate BPF—7 to 14 Days Postoperative (Pleural Fluid Cultures Are Positive But There Is No Frank Pus)

LATE BPF—More Than 14 Days Postoperative (Established Infection With Pus Is Present in the Pleural Space)

Principles of Definitive Management

Technique

Acute BPF

Late BPF—Transthoracic Approach

Late BPF—Transsternal Approach

18 • Tracheobronchoplasty for Tracheobronchomalacia

Perioperative Considerations

Anesthesia and Positioning

Instruments and Equipment

Technique

Open

Special Considerations for Robotic-Assisted Approach

Postoperative Care

19 • Nonintubated Thoracic Surgery

Introduction

Perioperative Considerations

Selection Criteria (Table 19.1)#tab19-1

Preparation

Local Anesthesia

Instruments and Equipment

Positioning

Technique

General Technique

Pleural Disease (Figures 19.7 and 19.8, Videos 19.1 and 19.2)#ff19-7

Pericardial Window (Figure 19.10, Video 19.3)#ff19-10

Lung Biopsy (Figures 19.11 and 19.12, Video 19.4)#ff19-11

Postoperative Care

20 • Lung Transplantation

Perioperative Considerations

Donor Operation

Recipient Operation

Instruments/Equipment and Monitoring

Positioning and Preparation

Technique

Circulatory Support During Lung Transplantation

Postoperative Care

MEDIASTINUM/DIAPHRAGM

21 • Thoracic Outlet Syndrome and First Rib Resection: Supraclavicular, Transaxillary, and Minimally Invasive Approaches

SUPRACLAVICULAR FIRST RIB RESECTION

Perioperative Considerations

Indications

Preoperative Testing

Instruments and Equipment

Positioning (Figure 21.2)#ff21-2

Technique

Incision and Initial Dissection (Figure 21.3)#ff21-3

Brachial Plexus and Subclavian Artery Dissection

Middle Scalene Division and Posterior Rib Exposure (Figure 21.6)#ff21-6

Postoperative Care

TRANSAXILLARY FIRST RIB RESECTION

Perioperative Considerations

Positioning (Figure 21.8)#ff21-8

Technique

Incision and Initial Dissection

Postoperative Care

ROBOTIC MINIMALLY INVASIVE APPROACH

Perioperative Considerations

Instruments and Equipment

Positioning

Technique (Figure 21.13 and 21.14)#ff21-13

Port Placement

Division of the Intercostal Muscle and Mediastinal Pleura

Division of Costal Cartilage and Posterior Rib Dissection

Division of the Serratus Anterior, Anterior/Middle Scalene, and Subclavius Muscle

Venolysis and Brachial Plexus Neurolysis

Removal of First Rib

Postoperative Care

22 • Sternoclavicular Resection

Perioperative Considerations

Preoperative Planning

Instruments and Equipment

Patient Positioning

Technique

Postoperative Care

23 • Chest Wall Resection and Reconstruction: Minimally Invasive Surgery/Thoracotomy

Perioperative Considerations

Instruments and Equipment

Anesthesia and Patient Positioning

Technique

Video-Assisted Thoracoscopic Surgery

Thoracotomy

Reconstruction (Skeletal Stabilization and Soft Tissue Coverage)

Reinforcement with Titanium Struts

Soft Tissue Coverage

Special Circumstances

Spine

Diaphragm

Postoperative Care

24 • Sympathectomy for Hyperhidrosis and Ventricular Dysrhythmias

Perioperative Considerations

Instruments and Equipment

Preparation and Positioning

Technique

Port Placement

Ablation of T2 to T3 Ganglia for Palmar and Axillary Hyperhidrosis

Ablation of Lower Stellate to T4 Ganglia for Dysrhythmias

Completion of Procedure

Postoperative Care

25 • Pectus Excavatum Repair

Perioperative Considerations

Instruments and Equipment

Anesthesia and Patient Positioning

Technique

Postoperative Care

26 • Diaphragmatic Plication

Preoperative Considerations

Anesthesia and Positioning

Technique

Open Transthoracic

Thoracoscopic

Laparoscopic

Robotic Transthoracic

Robotic Transabdominal

Postoperative Care

27 • Four Approaches to Thymectomy: Robotic/Video-Assisted Thoracoscopic Thymectomy/Sternotomy/Transcervical

GENERAL PERIOPERATIVE CONSIDERATIONS

THYMECTOMY BY MEDIAN STERNOTOMY

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Postoperative Care

THYMECTOMY BY VIDEO-ASSISTED TRANSCERVICAL APPROACH

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Postoperative Care

THYMECTOMY BY TRANSTHORACIC ROBOTIC AND/OR VATS APPROACHES

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Postoperative Care

SUMMARY

Acknowledgments

28 • Extended Superior Vena Cava Resection

Perioperative Considerations

Anesthesia and Patient Positioning

Technique

Types of Reconstruction

29 • Thoracic Duct Ligation

Perioperative Consideration

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Thoracoscopic Thoracic Duct Ligation

Authors’ Preferred Technique

Thoracic Duct Ligation via Thoracotomy

Laparoscopic CC Ligation for Refractory Chylothorax

Interventional Radiology Embolization

Postoperative Care

ESOPHAGEAL

30 • Antireflux Surgery/Fundoplication (Partial/Complete): Minimally Invasive/Open Surgery

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Port Placement, Robotic

Port Placement, Laparoscopic

Laparotomy

Postoperative Care

31 • Paraesophageal Hernia Repair: Robotic-Assisted Laparoscopic Approach/Transthoracic Approach

ROBOTIC-ASSISTED LAPAROSCOPIC APPROACH

Perioperative Considerations

Indications

Preoperative Testing

Instruments and Equipment

Positioning

Technique

Port Placement

Hernia Sac Dissection and Reduction of the Sac/Stomach

Hiatal Repair

Antireflux Procedure

Postoperative Care

LAPAROSCOPIC APPROACH

TRANSTHORACIC APPROACH

Perioperative Considerations

Instruments and Equipment

Positioning

Technique

Incision

Hernia Dissection

Hiatal Repair

Belsey Mark IV Fundoplication

Postoperative Care

32 • Collis Gastroplasty

Perioperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Technique

Port Placement

Surgical Approaches

Postoperative Care

Possible Complications and Functional Issues

33 • Reoperative Antireflux Surgery: Minimally Invasive Surgery/Thoracotomy

Perioperative Considerations

Instruments and Equipment

Patient Positioning

Techniques

Minimally Invasive Approach

Esophagogastric Dissection

Esophageal Mobilization ± Lengthening

Crural Repair

Fundoplication

Open Approach

Postoperative Care

Minimally Invasive Approach

Open Approach

34 • Achalasia

Perioperative Considerations

General

Preoperative Instruction

Technical Considerations

Transthoracic

Laparoscopic

Anesthesia and Positioning

Instruments and Equipment

Technique

Endoscopic

Anesthesia and Positioning

Instruments and Equipment

General Technical Points

Postoperative Considerations

General

Transthoracic

Endoscopic

35 • Zenker Diverticulum

Perioperative Considerations

Instruments and Equipment

Patient Positioning

Technique

Transoral Endoscopic Diverticulectomy

Postoperative Care

36 • Epiphrenic Diverticulum Repair

Perioperative Considerations

Preoperative Evaluation

Preoperative Instructions

Technique

Left Thoracotomy Approach

Minimally Invasive Approach

Postoperative Care

37 • Transhiatal Esophagectomy

Indications

Preoperative Considerations

Surgical Technique

Anesthetic Considerations

Surgical Considerations

Postoperative Care

Management of Complications

38 • Left Thoracoabdominal Esophagectomy

Perioperative Considerations

Instruments and Equipment

Anesthesia Considerations

Patient Positioning

Technique

Thoracic Portion

The Abdominal Portion

The Anastomosis

Closure and Drainage

Postoperative Care

39 • McKeown (3-Hole) Esophagectomy

Indications

Perioperative Considerations

Technique

Thoracic Component

Abdominal Component

Cervical Component

Postoperative Care

Management of Common Complications

40 • Ivor Lewis (Robotic-Assisted Minimally Invasive/Open) Esophagectomy

Perioperative Consideration

Anesthesia and Patient Positioning

Instruments and Equipment

ABDOMINAL PORTION

Port Placement for Laparoscopic surgery

Technique

THORACIC PORTION

Port Placement for Thoracoscopic portion

Technique

Postoperative Care

41 • Colon Interposition

Choice of Esophageal Substitution

Perioperative Considerations

Instruments and Equipment

Positioning

Technique

Mobilizing Transverse and Descending Colon

Conduit Position

Preparation of the Mediastinal Passage

Preparation of Esophagus and Conduit

Conduit Transposition to the Neck

Sequence of Anastomoses

Feeding Tube

Postoperative Care

42 • Repair of Esophageal Perforation

Perioperative Considerations

General

Diagnosis

Initial Management

Indications for Intervention

Interventions for Management

Choice of Intervention

Anesthesia and Positioning

VIDEO-ASSISTED THORACOSCOPIC WASHOUT AND DRAINAGE

Perioperative Considerations

Indications

Instruments and Equipment

Technique

ENDOSCOPIC STENT PLACEMENT

Perioperative Considerations

Indications

Instruments and Equipment

Technique (Video 42.1)

OPEN REPAIR VIA THORACOTOMY

Perioperative Considerations

Indications

Instruments and Equipment

Technique (Video 42.2)

ESOPHAGECTOMY

Perioperative Considerations

Indications

CERVICAL WASHOUT AND WIDE DRAINAGE

Perioperative Considerations

Indications

Technique

POSTOPERATIVE CARE

ENDOSCOPY

43 • Rigid Bronchoscopy and Acute Management of Tracheal Stenosis

Perioperative Considerations

Instruments and Equipment

Anesthesia and Patient Positioning

Technique

Postoperative Care

44 • Endobronchial Ultrasound and Navigational Bronchoscopy

Perioperative Considerations

Instruments and Equipment

Endobronchial Ultrasound

Navigational Bronchoscopy

Anesthesia and Patient Positioning

Technique

EBUS-TBNA: General Principles

EBUS-TBNA: Nodal Assessment

Navigational Bronchoscopy

Postoperative Care

45 • Mediastinoscopy and Potential Complications

Perioperative Considerations

Positioning, Instructions, and Equipment

Technique

Postoperative Care

46 • Esophagogastroduodenoscopy

Perioperative Considerations

Indications

Relative Contraindications

Technique

ESOPHAGEAL STENT PLACEMENT

Perioperative Considerations

Indications for Stents

Contraindications for Stents

Technique

47 • Endoscopic Ultrasound, Endoscopic Mucosal Resection, and Endoscopic Submucosal Dissection

Introduction

Endoscopic Ultrasound

Instruments and Equipment

Anesthesia and Patient Positioning

Principles of Endoscopic Ultrasound

Endoscopic Mucosal Resection

Preoperative Considerations

Anesthesia and Patient Positioning

Instruments and Equipment

Principles of EMR Technique

Endoscopic Technique (Video 47.1)

Endoscopic Submucosal Dissection

Instruments and Equipment

Technique

Postoperative Care

Early Potential Complications

Late Potential Complications

48 • Whole Lung Lavage for Pulmonary Alveolar Proteinosis

Perioperative Considerations

Double-Lumen Endotracheal Tube Considerations

Patient Positioning

Instruments and Equipment

Technique

Postoperative Care

Troubleshooting

Patient’s Oxygen Saturation Is Falling

Volume of Lavage Fluid Instilled Cannot Be Suctioned Out

Index

 

An aparitie	24 sep 2024
Autor	Yolonda Colson, Christopher Morse
Dimensiuni	213 x 276 mm
Editura	LWW
Format	Paperback
ISBN	9781975171933
Limba	Engleza
Nr pag	480