Procedures: Fellow Case Report Poster - Procedures |

Use of Laparoscopic Suction Irrigator With Rigid Pleuroscope in Medical Thoracoscopy FREE TO VIEW

George Cheng, MD; Adnan Majid, MD; Jose Cardenas-Garcia, MD; Christopher Manley, MD; Erik Folch, MD
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Beth Israel Deaconess Medical Center, Boston, MA

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):981A. doi:10.1016/j.chest.2016.08.1087
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SESSION TITLE: Fellow Case Report Poster - Procedures

SESSION TYPE: Affiliate Case Report Poster

PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM

INTRODUCTION: Medical thoracoscopy and video-assisted thoracic surgery (VATS) describe varies minimally invasive procedure to access pleural space, differing mostly on the approach to anesthesia, the number of entry points, and equipment used.1 Here we describe our experience of using of suction irrigator with rigid thoracoscope in lysis of adhesions.

CASE PRESENTATION: 81 years old female with Stage IV NSCLC on Nivolumab with known recurrent malignant pleural effusion diagnosed in May 2015, who underwent Pleurex catheter placement on 10/7/2015 complicated by catheter occlusion that did not have a lasting response to tPA treatment. She underwent a medical throacoscopy with lysis of adhesions and talc pleurodesis on 10/30/2015. During the procedure, complex extensive adhesions were lysed with ease using suction irrigator (StrykerFlow 2, Stryker, Kalamazoo, MI) through the rigid thoracoscope under direct visualization. Talc pleurodesis was performed after. Successful pleurodesis was confirmed on followup clinic visit with significant symptom improvement.

DISCUSSION: Since the initial report of endoscopic evaluation of chest cavity in 1866, the equipment and approach of thoracoscopy has significantly improved over the past 150 years. Concurrently, laparoscopic surgery has also brought with it a diverse range of tools that are designed for minimally invasive surgery.2,3 The convergence between the two fields is an exciting area to explore for tools that can be used interchangeably. Suction Irrigator use during medical thoracoscopy is one of the examples.

CONCLUSIONS: Use of suction irrigator in medical thoracoscopy can significantly aid in lysis of adhesions and decrease operative difficulty. Future studies will examine the use of suction irrigator to reduce operative time and clinical outcome.

Reference #1: 1. Lee P, Colt HG. Pleuroscopy in 2013. Clin Chest Med. 2013;34(1):81-91.

Reference #2: 2. Arias S, Semaan R, Lee H, Molena D, Feller-Kopman D, Yarmus L. Tridimensional Medical Thoracoscopy. Ann Am Thorac Soc. 2015;12(6):945-947.

Reference #3: 3. Hallifax RJ, Corcoran JP, Psallidas I, Rahman NM. Medical thoracoscopy: Survey of current practice-How successful are medical thoracoscopists at predicting malignancy? Respirology. 2015.

DISCLOSURE: The following authors have nothing to disclose: George Cheng, Adnan Majid, Jose Cardenas-Garcia, Christopher Manley, Erik Folch

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