Equis ISSN 2398-2977

Thorax: thoracoscopy

Contributor(s): Christopher Brown, A T Fischer, Dwayne Rodgerson

Introduction

  • Permits direct visual inspection of the thoracic cavity with minimal invasion.

Uses

Advantages

  • Better visualization:
    • Permits thorough inspection of thoracic anatomy when lung collapsed; contralateral lung visible through dorsal mediastinal membrane.
  • Reduced pain and post-operative discomfort.
  • Reduced length of procedure.
  • Reduced hospital stay.
  • Lung collapse is well tolerated; degree and duration of pneumothorax can easily be regulated with suction.

Disadvantages

  • Cannot visualize easily (with standing procedure):
    • Ventral cranial diaphragmatic region.
    • Cranial mediastinal surfaces.
    • Cranial to the aortic root.
  • Visualization also decreases with:
    • Fibrinous pleuritis or adhesions.
  • Discomfort due to positioning of portal during cranial direction of endoscope, particularly with more anterior (8th intercostal space).
  • Cardiopulmonary changes (independent of sedation effects) exacerbate the effects of sedation, eg decreased cardiac output (due to loss of negative pleural pressure and reduced venous return to heart during pneumothorax; may also be an effect of the collasped pulmonary mass on the heart base), increased systemic and pulmonary vascular resistances (associated with surgical stimulus, systemic hypertension and hypoxemia).

Requirements

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Preparation

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Procedure

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Aftercare

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Peroni J F et al (2001) Equine thoracoscopy - normal anatomy and surgical technique. Equine Vet J 33 (3), 231-237 PubMed.
  • Peroni J F et al (2000) Pleuropulmonary and cardiovascular consequences of thoracoscopy performed in healthy standing horses. Equine Vet J 32 (4), 280-286 PubMed.
  • Vachon A & Fischer A T (1998) Thoracoscopy in the horse - diagnostic and therapeutic indications in 28 cases. Equine Vet J 30 (6), 467-475 (Detailed description of procedure, indications and outcomes) PubMed.


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