Video-assisted thoracoscopic surgery in the prone position

Area of Science:

• Minimally Invasive Spine Surgery
• Thoracic Surgery
• Spinal Deformity Correction

Background:

• Traditional video-assisted thoracoscopic surgery (VATS) for spinal deformities typically involves patients in the lateral position.
• This approach often necessitates the use of a double-lumen endotracheal tube to deflate the ipsilateral lung.

Purpose of the Study:

• To evaluate the benefits and safety of a novel VATS technique for spinal deformities utilizing the prone position.
• To present the initial findings of this technique as the first study to explore the prone approach.

Main Methods:

• A review of 27 consecutive patients undergoing VATS for anterior release and discectomy in the prone position.
• The prone positioning facilitates gravity-assisted lung retraction, eliminating the need for a double-lumen endotracheal tube.

Main Results:

• All 27 procedures were successfully completed using the prone VATS technique.
• Average operative time for the anterior approach was 129 minutes with an average blood loss of 221 mL.
• An average of 3.3 discs were resected per patient.

Conclusions:

• The prone position is a safe and effective approach for VATS in spinal deformity treatment.
• This method eliminates the need for a double-lumen tube, utilizes gravity for lung retraction, and saves operative time by avoiding patient repositioning.
• Surgical times and blood loss are comparable or favorable to those reported for VATS in the lateral position.