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Minimal access extrapleural esophagoesophagostomy
Joselito Tantoco1, Jon Rossman, Laramie Dixey
1Miniature Access Surgery Teaching, Training, and Robotic Research Center, The Women's and Children's Hospital of Buffalo University at Buffalo, Buffalo, NY 14222, USA.
Journal of Pediatric Surgery
|June 9, 2004
Summary
This study introduces a novel, less-invasive extrapleural approach for minimal access repair of esophageal atresia. Thoracoscopic guidance and balloon dissection successfully created an extrapleural working space for esophagoesophagostomy.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Minimal access repair of esophageal atresia is increasingly adopted.
- Current methods often involve a transpleural approach.
- A 2-cm incision extrapleural approach has been previously described.
Purpose of the Study:
- To develop a less-invasive extrapleural approach for esophagoesophagostomy.
- To improve upon existing minimal access techniques for esophageal atresia repair.
Main Methods:
- Utilized a piglet model for technique development.
- Employed transpleural thoracoscopy for direct vision extrapleural dissection.
- Created and expanded an extrapleural space using needles, spatulas, and progressively larger balloon catheters through multiple port sites.
Main Results:
- Thoracoscopic guidance was effective in facilitating dissection.
- Balloon dissection successfully created an adequate extrapleural working space.
- The extrapleural space did not communicate with the transpleural port site.
Conclusions:
- A novel minimal access extrapleural approach for esophagoesophagostomy was successfully developed.
- This technique offers a less-invasive alternative to existing minimal access methods.
- The approach provides an attractive option for esophageal atresia repair.